Stellate ganglion block for treating post-COVID-19 parosmia
Bita R. Naimi BA
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorEmily Garvey BA
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorMegha Chandna BA
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAlexander Duffy MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorStephanie R. Hunter PhD
Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA
Search for more papers by this authorShreya Mandloi BS
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorChase Kahn MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorDouglas Farquhar MD, MPH
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorGlen D'Souza MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorMindy Rabinowitz MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorMarc Rosen MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorElina Toskala MD, MBA, PhD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorJohannes B. Roedl MD
Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAdam Zoga MD, MBA
Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorGurston Nyquist MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCorresponding Author
David Rosen MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Correspondence
David Rosen, MD, Department of Otolaryngology, Thomas Jefferson University Hospital, 925 Chestnut St 6th Floor, Philadelphia, PA, USA.
Email: [email protected]
Search for more papers by this authorBita R. Naimi BA
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorEmily Garvey BA
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorMegha Chandna BA
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAlexander Duffy MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorStephanie R. Hunter PhD
Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA
Search for more papers by this authorShreya Mandloi BS
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorChase Kahn MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorDouglas Farquhar MD, MPH
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorGlen D'Souza MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorMindy Rabinowitz MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorMarc Rosen MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorElina Toskala MD, MBA, PhD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorJohannes B. Roedl MD
Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorAdam Zoga MD, MBA
Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorGurston Nyquist MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCorresponding Author
David Rosen MD
Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
Correspondence
David Rosen, MD, Department of Otolaryngology, Thomas Jefferson University Hospital, 925 Chestnut St 6th Floor, Philadelphia, PA, USA.
Email: [email protected]
Search for more papers by this authorAbstract
Background
Post-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).
Methods
Retrospective 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.
Results
Forty-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).
Conclusion
SGB 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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