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. 2024 Jan;170(1):272-276.
doi: 10.1002/ohn.530. Epub 2023 Sep 26.

Stellate Ganglion Block for the Treatment of COVID-19-Induced Olfactory Dysfunction: A Prospective Pilot Study

Andrew M Peterson  1 , Brevin J Miller  1 , Dorina Kallogjeri  1 , Jay F Piccirillo  1 , Sara Kukuljan  1 , Lauren T Roland  2 , John S Schneider  2 , Lara W Crock  3 , Nyssa F Farrell  2
Affiliations

Stellate Ganglion Block for the Treatment of COVID-19-Induced Olfactory Dysfunction: A Prospective Pilot Study

Andrew M Peterson et al. Otolaryngol Head Neck Surg. 2024 Jan.

Abstract

Objective: The objective of this study was to explore the safety and feasibility of stellate ganglion blocks (SGBs) to treat persistent COVID-19-induced olfactory dysfunction (OD). Secondarily, the goal was to determine effect sizes to plan a future randomized clinical trial.

Study design: Prospective case series.

Setting: Quaternary Care Academic Medical Center.

Methods: In this single-arm pilot trial, adult participants with a COVID-19 diagnosis ≥ 12 months prior to enrollment with OD underwent bilateral SGBs. Subjects were followed for 1 month after completion of SGB. The primary outcome measure was the change in the Clinical Global Impression-Improvement Scale for smell loss. Secondary outcome measures included changes in the University of Pennsylvania Smell Identification Test (UPSIT) and Olfactory Dysfunction Outcomes Rating (ODOR).

Results: Twenty participants were enrolled with a mean (SD) age of 46 (11) years and a mean (SD) duration of OD of 21 (5) months. At 1 month, 10 (50%) participants experienced at least slight subjective improvement in their OD, 11 (55%) attained a clinically meaningful improvement in smell identification using the UPSIT, and 7 (35%) achieved a clinically meaningful improvement in olfactory-specific quality of life (QoL) measured by the ODOR. The median difference between UPSIT scores at baseline and 1 month was 6 (95% confidence interval: 3-11), exceeding the minimal clinically important difference of 4. There were no serious adverse events.

Conclusion: Sequential SGBs for COVID-19-associated OD were safe and associated with modest improvements in subjective olfaction, odor identification, and olfactory-specific QoL. A placebo-controlled trial is warranted to determine the efficacy of SGBs for COVID-19-associated OD.

Keywords: COVID-19; anosmia; hyposmia; olfaction; stellate ganglion.

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Conflict of interest statement

Conflicts of Interest: Dr. Peterson, Dr. Kallogjeri, and Dr. Piccirillo are co-authors of the Olfactory Dysfunction Outcomes Rating (ODOR).

Figures

Figure 1
Figure 1
UPSIT Scores at Baseline, One-Week, and One-Month. This figure represents a box and whisker plot of UPSIT scores at baseline, one-week, and one month, which correspond to visits 1, 2, and 3, respectively.
See this image and copyright information in PMC

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