International Rhinologic Society Rhinology 0300-0729 2025 11 30 Web-application guided bimodal olfactory training for COVID-19 patients: a randomized trial EN C. VandersteenInstitut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, UR2CA-REBOOT, Université Côte d’Azur, Nice, Alpes- Maritimes, France Université Côte d’Azur, laboratoire CoBTeK, Nice, Alpes-Maritimes, France M. PayneUniversité Côte d’Azur, laboratoire CoBTeK, Nice, Alpes-Maritimes, France Université Côte d’Azur, Département d’Orthophonie de Nice, UFR Médecine, Nice, Alpes-Maritimes, France C. Becker Givaudan Perfumery school Director, Argenteuil, France S. Bernier Institut NeuroMod, INRIA Centre de recherche Sophia Antipolis, Université Côte d’Azur, Sophia Antipolis, Alpes-Maritimes, France A. Derreumaux Université Côte d’Azur, laboratoire CoBTeK, Nice, Alpes-Maritimes, France N. Guevara Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, UR2CA-REBOOT, Université Côte d’Azur, Nice, Alpes- Maritimes, France L. Castillo Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, UR2CA-REBOOT, Université Côte d’Azur, Nice, Alpes- Maritimes, France A. PlonkaUniversité Côte d’Azur, laboratoire CoBTeK, Nice, Alpes-Maritimes, France Institut NeuroMod, INRIA Centre de recherche Sophia Antipolis, Université Côte d’Azur, Sophia Antipolis, Alpes-Maritimes, France V. ManeraUniversité Côte d’Azur, laboratoire CoBTeK, Nice, Alpes-Maritimes, France Université Côte d’Azur, Département d’Orthophonie de Nice, UFR Médecine, Nice, Alpes-Maritimes, France Institut NeuroMod, INRIA Centre de recherche Sophia Antipolis, Université Côte d’Azur, Sophia Antipolis, Alpes-Maritimes, France X. Fernandez Institut de Chimie de Nice, Université Nice Côte d’Azur, Nice, Alpes-Maritimes, France A. GrosInstitut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, UR2CA-REBOOT, Université Côte d’Azur, Nice, Alpes- Maritimes, France Université Côte d’Azur, laboratoire CoBTeK, Nice, Alpes-Maritimes, France Université Côte d’Azur, Département d’Orthophonie de Nice, UFR Médecine, Nice, Alpes-Maritimes, France Journal Article 3363 10.4193/Rhin24.273 BACKGROUND: Many Post-Acute COVID-19 Syndrome (PACS) patients continue to experience persistent dysosmia up to two years post-pandemic. Cognitive and semantic memory functions, along with olfactory associative areas, may be affected in PACS without olfactory recovery. Visual-olfactory bimodal olfactory training may stimulate these areas. This study evaluates the olfactory recovery using a new bi-modal training kit, MaMadeleine™, assisted by a web application. METHODOLOGY: A prospective randomised study (Nov 2021–June 2022) included PACS patients aged ≥14 with post-infectious olfactory dysfunction. Patients were randomized for two months of simple (A) or semantic (B) visual-olfactory training. Evaluations included clinical assessments, Sniffin’ Sticks Tests, and quality-of-life questionnaires. Adherence to treatment was monitored via the web application. RESULTS: We included 83 patients, on average 13±5.6 months after COVID-19. Olfactory training using MaMadeleine™ led to subjective orthoand retro-nasal olfactory improvement in 79.4% (n=58) and 58.9% (n=43) of patients, respectively, with Sniffin’ Sticks Test scores increasing from 26.5±7.5 to 29.1±7.4. Both groups saw a 20% decrease in parosmia and phantosmia. No significant differences in recovery were observed between groups, although exploratory findings in a small subgroup (n=10) with semantic memory impairment suggest a possible benefit of bimodal training, warranting further investigation. Quality of life improved significantly in both groups. Adherence was better in group B than in group A. CONCLUSIONS: MaMadeleine™ training improves subjective olfactory function, psychophysical test results, and quality of life in PACS patients with olfactory dysfunction. Multimodal training enhances adherence. Further studies are needed in semantic memory-impaired patients.