The Efficacy of Stellate Ganglion Block in Sensorineural Anosmia Patients Unresponsive to Steroid Therapy

Moon, Ho Sik; Lee, Hae Jin; Sung, Chih-Wei; Lim, Su Jin; Choi, Jin Hwan

doi:10.3344/kjp.2007.20.2.154

Cited by 8 publications

(13 citation statements)

References 10 publications

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“…Olfactory dysfunction related to inflammation shows limited response to oral or topical steroids [2,7,9,11]. However, various treatment modalities have no effect on the major causes of olfactory dysfunction, including idiopathic, trauma, toxins, and congenital [7,8]. In this study, although sample sizes were too small, there was no difference between the R and UR groups with regard to causes of olfactory dysfunction.…”

Section: Discussionmentioning

confidence: 79%

“…Causative factors, including nasal polyps, chronic sinusitis, and adenoid hypertrophy can be treated using surgery [2,10]. Olfactory dysfunction related to inflammation shows limited response to oral or topical steroids [2,7,9,11]. However, various treatment modalities have no effect on the major causes of olfactory dysfunction, including idiopathic, trauma, toxins, and congenital [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Also, some authors have reported that SGB has an effect on anosmia and hyposmia [7,8]. Lee et al [8] reported that SGB improved the olfactory sense by 71.1% in such cases.…”

Section: Discussionmentioning

confidence: 99%

“…However, these treatments have been reported to produce limited effects. Although the action mechanism of SGB on olfaction is still not well known, there are a few reports that olfactory dysfunction can be treated by SGB [7,8]. …”

Section: Introductionmentioning

confidence: 99%

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Long-term Results of Stellate Ganglion Block in Patients with Olfactory Dysfunction

et al. 2013

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BackgroundOlfactory dysfunction, including anosmia and hyposmia is difficult to treat. Although the mechanism is not well known, stellate ganglion block (SGB) is used to treat olfactory dysfunction. There are no prior studies on the long-term effects of SGB on olfactory dysfunction. The purpose of this study was to evaluate the continuity of therapeutic effects and patient satisfaction with SGB treatment.MethodsThis was a follow-up study carried out via a telephonic survey. The olfactory function of the patient was evaluated using a visual analog scale (VAS). We checked VAS three times: VAS-I (pre-treatment VAS), VAS-A (post-treatment VAS), and VAS-C (VAS at follow up telephone survey). We divided the subjects into 2 groups according to their responsiveness to SGB: the responsive (R group) and the unresponsive groups (UR group). Patient satisfaction was evaluated using a Likert scale.ResultsOut of the 40 subjects, 37 responded to the telephone survey. In the UR group, there was difference in the olfactory function. However, in the R group, there were significant VAS differences; VAS-I was 9.6 ± 0.7, VAS-A was 5.1 ± 4.2, and VAS-C was 2.7 ± 2.7 (P < 0.05). On the Likert scale, patient satisfaction was as follows: grade 1, 17 patients (45.9%); grade 2, 6 patients (16.2%); grade 3, 6 patients (16.2%); and grade 4, 8 patients (21.6%).ConclusionsSGB is a safe, long-lasting, and effective therapeutic modality for olfactory dysfunction treatment.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

“…Also, some authors have reported that SGB has an effect on anosmia and hyposmia [7,8]. Lee et al [8] reported that SGB improved the olfactory sense by 71.1% in such cases.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-term Results of Stellate Ganglion Block in Patients with Olfactory Dysfunction

et al. 2013

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“…Numerous drugs from multiple classes are associated with changes in smell and taste, including the ACE2 inhibitor losartan [19] and the sympathomimetic midodrine [20]. Improvement in anosmia after SGB has been reported previously, although the mechanism for the effect is unknown [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Stellate Ganglion Block Successfully Treats Long COVID/PASC: A Case Series

Liu¹,

Duricka²

2021

Preprint

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The SARS-CoV-2 pandemic has resulted in a secondary pandemic of individuals suffering from pernicious symptoms termed “Long COVID” or PASC. In spite of significant societal impact, the condition remains mysterious and effective treatment remains elusive. Individuals experience debilitating symptoms including fatigue, “brain fog,” loss or altered smell and/or taste, anxiety and depression. Most of these symptoms are included in the “sickness behavior response” initiated from the brainstem when levels of circulating pro-inflammatory cytokines are high. Ordinarily a feedback loop prevents excessive production of these cytokines, however the SARS-CoV-2 virus has demonstrated the ability to induce the sympathetic nervous system (SNS), likely due to imbalance between ACE1 and ACE2 activity. Persistent sympathetic drive causes increased cytokine release, which interferes with the feedback loop that ends “sickness behaviors.” The stellate ganglion is a paravertebral collection of sympathetic nerves located in the cervical region that provides a convenient entry point to reduce activity of the SNS using local anesthetic blockade. The stellate ganglion block (SGB) has a well-established safety and efficacy profile for a variety of conditions involving the SNS. In this case report series, we treated three consecutive “Long COVID” patients with SGB. All three patients reported significant and durable improvement in symptoms including fatigue, “brain fog,” and smell and taste derangements. Our findings provide evidence implicating dysautonomia as the main etiology of Long COVID/PASC symptoms and suggest that SGB is an effective intervention for this condition with the potential to change the course of the second COVID pandemic, “Long COVID”/PASC.

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Stellate ganglion block for treating post‐COVID‐19 parosmia

Naimi,

Garvey,

Chandna

et al. 2024

Int Forum Allergy Rhinol

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BackgroundPost‐COVID parosmia may be due to dysautonomia and sympathetic hyperresponsiveness, which can be attenuated by stellate ganglion block (SGB). This study evaluates SGB as a treatment for post‐COVID olfactory dysfunction (OD).MethodsRetrospective case series with prospective data of patients with post‐COVID OD undergoing unilateral (UL) or bilateral (BL) SGB. Patients completed Brief Smell Identification Tests (BSIT) (12 points maximum) and post‐procedure surveys including parosmia severity scores on a scale of 1 (absent) to 10 (severe). Scores were compared from before treatment (pre‐SGB) to after first (SGB1) or second (SGB2) treatments in overall, UL, and BL cohorts.ResultsForty‐seven patients with post‐COVID OD underwent SGB, including 23 UL and 24 BL. Twenty patients completed pre‐ and post‐SGB BSITs (eight UL and 12 BL). Twenty‐eight patients completed postprocedure surveys (11 UL and 17 BL). There were no differences in BSIT scores from pre‐SGB to post‐SGB1 or post‐SGB2 for the overall (p = 0.098), UL (p = 0.168), or BL (p = 0.230) cohorts. Parosmia severity for the overall cohort improved from pre‐SGB (8.82 ± 1.28) to post‐SGB1 (6.79 ± 2.38) and post‐SGB2 (5.41 ± 2.35), with significant differences from pre‐SGB to post‐SGB1 (p < 0.001) and pre‐SGB to post‐SGB2 (p < 0.001), but not post‐SGB1 to post‐SGB2 (p = 0.130). Number of parosmia triggers decreased for overall (p = 0.002), UL (p = 0.030) and BL (p = 0.024) cohorts. Quality of life (QOL) improved for all cohorts regarding food enjoyment, meal preparation, and socialization (p < 0.05).ConclusionSGB may improve subjective parosmia and QOL for patients with post‐COVID OD, however it may not affect odor identification. Further placebo‐controlled studies are warranted.

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The Efficacy of Stellate Ganglion Block in Sensorineural Anosmia Patients Unresponsive to Steroid Therapy

Cited by 8 publications

References 10 publications

Long-term Results of Stellate Ganglion Block in Patients with Olfactory Dysfunction

Long-term Results of Stellate Ganglion Block in Patients with Olfactory Dysfunction

Stellate Ganglion Block Successfully Treats Long COVID/PASC: A Case Series

Stellate ganglion block for treating post‐COVID‐19 parosmia

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