Evaluation of effectiveness of stellate ganglion block (SGB) treatment of sudden hearing loss

Takinami, Yoshikazu

doi:10.3109/00016489.2011.616911

Cited by 11 publications

(10 citation statements)

References 11 publications

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“…The eventual involvement of internal ear circulatory disturbance causes metabolic disturbance of the inner ear cells, decreases in oxidation of metabolic substrates, and edema, resulting in irreversible changes. The resorption of edema is promoted by arterial relaxation from sympathetic blockade 6,15). Takinami15) reported that stellate ganglion block favorably affected outcomes in patients with unilateral SSNHL given a prior or concomitant course of systemic corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

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Combination Therapy with Systemic Steroids, an Antiviral Agent, Anticoagulants, and Stellate Ganglion Block for Treatment of Sudden Sensorineural Hearing Loss

Park

Lee

et al. 2012

Korean J Audiol

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Background and ObjectivesSudden sensorineural hearing loss (SSNHL) is commonly defined as a loss of at least 30 dB in three contiguous frequencies occurring within 3 days. Systemic steroid administration has become the most widely accepted treatment option for SSNHL. Since viral infection and vascular compromise are considered specific causes of SSNHL, antiviral agents, anticoagulants, and stellate ganglion block have been used for its treatment, although the evidence of their effectiveness is weak. The present study evaluated the hearing recovery rate in the combination therapy group (systemic steroids, antiviral agent, anticoagulants, and stellate ganglion block) in comparison with patients treated with systemic steroids alone.Subjects and MethodsA total of 85 patients diagnosed with SSNHL were treated with combination therapy (group A, 46 patients) or systemic steroids only (group B, 39 patients). Hearing improvement was defined as a hearing gain of more than slight improvement using Siegel's criteria. All patients were treated with a 10-day course of systemic steroids (10-mg dexamethasone for 5 days, followed by tapering for 5 days). Acyclovir, heparin, and stellate ganglion block were included in the group A treatment regimen.ResultsThe overall rate of hearing improvement was 60.9% (28/46 patients) in group A, which was significantly higher than that (38.5%, 15/39 patients) in group B. The distribution of prognostic factors was not significantly different between the two groups with the exception of the degree of initial hearing loss, which was more severe in group A. Upon analysis according to prognostic factors, group A showed a better hearing improvement recovery rate than group B in patients with hearing loss >70 dB, age >41 years, dizziness, and early treatment (<1 week).ConclusionsThus SSNHL patients treated with combination therapy have a higher likelihood of hearing improvement than those treated with systemic steroids alone.

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Section: Discussionmentioning

confidence: 99%

“…The resorption of edema is promoted by arterial relaxation from sympathetic blockade 6,15). Takinami15) reported that stellate ganglion block favorably affected outcomes in patients with unilateral SSNHL given a prior or concomitant course of systemic corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

Combination Therapy with Systemic Steroids, an Antiviral Agent, Anticoagulants, and Stellate Ganglion Block for Treatment of Sudden Sensorineural Hearing Loss

Park

Lee

et al. 2012

Korean J Audiol

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“…The therapeutic effect was judged by comparing the mean hearing ability at presentation with that observed at the time that the patient's symptoms became nearly stable, based on the hearing improvement criteria described in the Report of the Survey Research Group of Acute Highly Impaired Hearing designated by the Ministry of Health and Welfare in 1985 (table 3). 5 Statistical analysis. A hierarchical cluster analysis was performed.…”

Section: Methodsmentioning

confidence: 99%

Analysis of the Audiogram Shape in Patients with Idiopathic Sudden Sensorineural Hearing Loss using a Cluster Analysis

Watanabe

Suzuki

2018

Ear Nose Throat J

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We performed a cluster analysis to classify the audiogram shape in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). We also investigated whether the audiogram shape is a prognostic indicator in the management of ISSNHL. A total of 115 inpatients with ISSNHL treated between 2001 and 2010 were analyzed. The data collected included age, sex, duration of hearing loss at the time of treatment, and the presence or absence of tinnitus, vertigo, diabetes, nystagmus, and canal paresis. A hierarchical cluster analysis was performed using the hearing threshold for each frequency on audiograms as variables. A logistic regression model was used for the prognostic analysis. The audiogram shape was classified into four clusters: (1) crossing horizontally pattern of all tones; (2) up-sloping pattern of low-tone loss; (3) deaf pattern; and (4) down-sloping pattern of high-tone loss. The age of the patient, presence of canal paresis, and audiogram shape showed statistically significant relationships with hearing improvement. The audiogram shape based on the cluster analysis demonstrated a significant relationship with hearing improvement in patients with ISSNHL. Further studies are needed to elucidate the underlying etiology of each audiogram shape.

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“…SGB is a well-established pain management procedure in wide use since 1920 with a high safety profile [30] and an extremely low complication rate of 1.7 per 1,000 procedures [31]. The procedure is commonly used to treat pain associated with many conditions including chronic regional pain syndrome (CRPS) types I and II, vascular insufficiency/occlusive vascular disorders of the upper extremities, postherpetic neuralgia, phantom limb pain or amputation stump pain, Quinine poisoning, sudden hearing loss and tinnitus, hyperhidrosis of the upper extremity, cardiac arrhythmias, ischemic cardiac pain, Bell's palsy, trigeminal neuralgia, migraine headaches, neuropathic pain, Meniere's syndrome and hot flashes [32][33][34][35][36][37][38][39][40].…”

Section: Sgb: Non-psychiatric Indications and Hypothesized Mechanism(mentioning

confidence: 99%

Use of Stellate Ganglion Block for Refractory Post-Traumatic Stress Disorder: A Review of Published Cases

Navaie

Keefe

Hickey³

et al. 2014

J Anesth Clin Res

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Introduction: The lifetime prevalence of post-traumatic stress disorder (PTSD) is estimated to be 7.3% in the U.S. population, 10-20% among active duty service members and 35-40% among veterans. Overall success rates of evidence-based therapies for PTSD are low, leading clinicians to explore new therapeutic options. This study evaluated all published articles on the use of stellate ganglion block (SGB) as an adjunctive therapy for treatmentrefractory PTSD. Methods: EMBASE, PubMed, PsychINFO and Cochrane databases were searched using keyword combinations including stellate ganglion block, SGB, post-traumatic stress disorder, and PTSD. Articles were restricted to English language with no date delimiter. Twelve publications were identified, seven of which were eliminated due to lack of case data, duplicate patient sample, or descriptive reports with no standardized PTSD symptom assessment. Twenty-four cases from five articles were examined further by two independent evaluators who extracted data on sociodemographic and clinical characteristics including PTSD symptoms, comorbidities, and treatment history. Interrater reliability showed complete agreement (κ=1.0). Results: Cases were predominantly male (n=21, 88%) and active duty military (n=14, 58%) or veterans (n=8, 33%) with combat-related PTSD. The average age was 40.5 years (±10.0 SD). All cases had received >1 year of psychotherapy and pharmacotherapy before SGB. Seventeen cases (71%) received one SGB, seven (29%) received multiple SGBs. Clinically meaningful improvements were observed in 75% (n=18) of cases after SGB, with significant differences in mean PTSD scores pre-(69.5 ± 26.6) and post-SGB (34.2 ± 32.5) across cases (p<0.001). The effect size was relatively large (d=1.2). On average, PTSD improved by 50.4% (± 30.9 SD; range: 6.3-98.4) for cases with one SGB and 69.0% (± 28.0 SD; range: 9.2-93.5) for cases with multiple SGBs. Conclusions: Most patients with treatment-refractory PTSD experienced rapid improvement after SGB. Robust clinical trials are needed to determine SGB's treatment efficacy for PTSD. J o u rn al of A n e s th es ia & C li n ic a l Resea rc h

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Evaluation of effectiveness of stellate ganglion block (SGB) treatment of sudden hearing loss

Abstract: Propensity score matching yielded 48 pairs. The mean therapeutic effect of the SGB was calculated to be 0.40 ± 0.20 (mean ± standard error, p = 0.051).

Cited by 11 publications

References 11 publications

Combination Therapy with Systemic Steroids, an Antiviral Agent, Anticoagulants, and Stellate Ganglion Block for Treatment of Sudden Sensorineural Hearing Loss

Combination Therapy with Systemic Steroids, an Antiviral Agent, Anticoagulants, and Stellate Ganglion Block for Treatment of Sudden Sensorineural Hearing Loss

Analysis of the Audiogram Shape in Patients with Idiopathic Sudden Sensorineural Hearing Loss using a Cluster Analysis

Use of Stellate Ganglion Block for Refractory Post-Traumatic Stress Disorder: A Review of Published Cases

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