Korean J Pain.  2013 Jan;26(1):57-61. 10.3344/kjp.2013.26.1.57.

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

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. chsung@catholic.ac.kr

Abstract

BACKGROUND
Olfactory 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.
METHODS
This 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.
RESULTS
Out 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%).
CONCLUSIONS
SGB is a safe, long-lasting, and effective therapeutic modality for olfactory dysfunction treatment.

Keyword

anosmia; olfaction; stellate ganglion block; treatment

MeSH Terms

Arginine Vasopressin
Follow-Up Studies
Humans
Olfaction Disorders
Patient Satisfaction
Smell
Stellate Ganglion
Telephone
Arginine Vasopressin

Figure

  • Fig. 1 Changes of subjective olfactory function after SGB. All values are mean ± SD. Subjective olfactory function was measured at different study periods. SGB: stellate ganglion block. VAS: visual analog scale. I: pre-treatment. A: post-treatment. C: at follow-up telephone survey. *P < 0.05 versus UR group. †P < 0.05 versus VAS-I.


Reference

1. Schiffman SS. Taste and smell losses in normal aging and disease. JAMA. 1997; 278:1357–1362. PMID: 9343468.
Article
2. Gaines AD. Anosmia and hyposmia. Allergy Asthma Proc. 2010; 31:185–189. PMID: 20615320.
Article
3. Pignatelli A, Belluzzi O. Menini A, editor. Neurogenesis in the adult olfactory bulb. The neurobiology of olfaction. 2010. Boca Raton (FL): CRC Press;Chapter 11. Available at http://www.ncbi.nlm.nih.gov/books/NBK55980/.
Article
4. Sivam A, Jeswani S, Reder L, Wang J, DeTineo M, Taxy J, et al. Olfactory cleft inflammation is present in seasonal allergic rhinitis and is reduced with intranasal steroids. Am J Rhinol Allergy. 2010; 24:286–290. PMID: 20819468.
Article
5. Passàli GC, Ralli M, Galli J, Calò L, Paludetti G. How relevant is the impairment of smell for the quality of life in allergic rhinitis? Curr Opin Allergy Clin Immunol. 2008; 8:238–242. PMID: 18560299.
Article
6. Schiffman SS. Taste and smell in disease (second of two parts). N Engl J Med. 1983; 308:1337–1343. PMID: 6341845.
7. Moon HS, Lee HJ, Sung CH, Lim SJ, Choi JH. The efficacy of stellate ganglion block in sensorineural anosmia patients unresponsive to steroid therapy. Korean J Pain. 2007; 20:154–157.
Article
8. Lee NS, Yoon HR, Park JW, Yum JH, Seo JH, Cho JH, et al. The efficacy of stellate ganglion block in olfactory disorder following upper respiratory tract infection. Korean J Otolaryngol-Head Neck Surg. 2003; 46:568–571.
9. Bromley SM. Smell and taste disorders: a primary care approach. Am Fam Physician. 2000; 61:427–436. PMID: 10670508.
10. Hox V, Bobic S, Callebaux I, Jorissen M, Hellings PW. Nasal obstruction and smell impairment in nasal polyp disease: correlation between objective and subjective parameters. Rhinology. 2010; 48:426–432. PMID: 21442079.
Article
11. Mullol J, Obando A, Pujols L, Alobid I. Corticosteroid treatment in chronic rhinosinusitis: the possibilities and the limits. Immunol Allergy Clin North Am. 2009; 29:657–668. PMID: 19879441.
Article
12. Curatolo M, Bogduk N. Fishman SM, Ballantyne JC, Rathmell JP, editors. Diagnostic and therapeutic nerve blocks. Bonica's management of pain. 2010. 4th ed. Philadelphia: Lippincott Williams & Wilkins;p. 1401–1423.
13. Kakuyama M, Toda H, Osawa M, Fukuda K. The bilateral effect of stellate ganglion block on the facial skin blood flow. Reg Anesth Pain Med. 2000; 25:389–392. PMID: 10925936.
Article
14. Reden J, Mueller A, Mueller C, Konstantinidis I, Frasnelli J, Landis BN, et al. Recovery of olfactory function following closed head injury or infections of the upper respiratory tract. Arch Otolaryngol Head Neck Surg. 2006; 132:265–269. PMID: 16549746.
Article
15. Kaplan MS, Hinds JW. Neurogenesis in the adult rat: electron microscopic analysis of light radioautographs. Science. 1977; 197:1092–1094. PMID: 887941.
Article
16. Hack MA, Saghatelyan A, de Chevigny A, Pfeifer A, Ashery-Padan R, Lledo PM, et al. Neuronal fate determinants of adult olfactory bulb neurogenesis. Nat Neurosci. 2005; 8:865–872. PMID: 15951811.
Article
17. Bordey A. Adult neurogenesis: basic concepts of signaling. Cell Cycle. 2006; 5:722–728. PMID: 16582623.
Article
18. Leuner B, Kozorovitskiy Y, Gross CG, Gould E. Diminished adult neurogenesis in the marmoset brain precedes old age. Proc Natl Acad Sci U S A. 2007; 104:17169–17173. PMID: 17940008.
Article
19. Rochefort C, Gheusi G, Vincent JD, Lledo PM. Enriched odor exposure increases the number of newborn neurons in the adult olfactory bulb and improves odor memory. J Neurosci. 2002; 22:2679–2689. PMID: 11923433.
Article
20. Huang L, Bittman EL. Olfactory bulb cells generated in adult male golden hamsters are specifically activated by exposure to estrous females. Horm Behav. 2002; 41:343–350. PMID: 11971669.
Article
21. Hitoshi S, Maruta N, Higashi M, Kumar A, Kato N, Ikenaka K. Antidepressant drugs reverse the loss of adult neural stem cells following chronic stress. J Neurosci Res. 2007; 85:3574–3585. PMID: 17668856.
Article
22. Doetsch F. A niche for adult neural stem cells. Curr Opin Genet Dev. 2003; 13:543–550. PMID: 14550422.
Article
23. Lee NS, Kim BG, Park JM, Park YS, Kim SW, Kim SW, et al. The effect of superior cervical ganglionectomy on recovery of olfaction in induced anosmic mice. Korean J Otolaryngol-Head Neck Surg. 2005; 48:1462–1467.
24. Yu HG, Chung H, Yoon TG, Yum KW, Kim HJ. Stellate ganglion block increases blood flow into the optic nerve head and the peripapillary retina in human. Auton Neurosci. 2003; 109:53–57. PMID: 14638313.
Article
25. Takebayashi H, Tsuzuki K, Oka H, Fukazawa K, Daimon T, Sakagami M. Clinical availability of a self-administered odor questionnaire for patients with olfactory disorders. Auris Nasus Larynx. 2011; 38:65–72. PMID: 20594785.
Article
26. McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med. 1988; 18:1007–1019. PMID: 3078045.
Article
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