Ultrasound-Guided Stellate Ganglion Block for the Treatment of Tinnitus

[Nick47]

Conclusion:

Ultrasound-guided stellate ganglion block demonstrates superior efficacy in managing tinnitus compared to conventional drug therapy. This study underscores the potential of integrating advanced ultrasound technology into healthcare to optimize treatment outcomes for auditory disorders.

Ultrasound guided stellate ganglion block for the treatment of tinnitus - PubMed

BackgroundTinnitus, a common auditory disorder, significantly impacts patient quality of life and lacks universally effective treatments. The integration of advanced imaging technology like ultrasound in therapeutic interventions offers new possibilities in healthcare.ObjectiveThis study...

pubmed.ncbi.nlm.nih.gov

The effects are modest. It involved a moderately sized group. This is not the full paper, so it lacks detail.

 

[annV]

This is not the full paper, so it lacks detail.

More detail is here:

Sage Journals: Ultrasound-guided stellate ganglion block for the treatment of tinnitus

 

[Nick47]

More detail is here:

Thanks, @annV. Are you OK?

 

[withintention]

The results seem impressive to me.

• There were 80 participants, and 100% showed improvement. The results were statistically significant compared to the control group, which received a standard Lidocaine injection.
  
  
• The average THI score dropped from around 63 to about 38, which means a shift from Severe Disability to the borderline between Moderate and Mild Disability.
  
  
• The average SAS score went from roughly 56 to 39, moving from Mild Anxiety to the Normal range.

I would go in for a shot once a week for results like that, without hesitation.

 

[Nick47]

The results seem impressive to me.

• There were 80 participants, and 100% showed improvement. The results were statistically significant compared to the control group, which received a standard Lidocaine injection.
  
  
• The average THI score dropped from around 63 to about 38, which means a shift from Severe Disability to the borderline between Moderate and Mild Disability.
  
  
• The average SAS score went from roughly 56 to 39, moving from Mild Anxiety to the Normal range.

I would go in for a shot once a week for results like that, without hesitation.

@withintention, now that I can see the full paper, I agree.

 

[hey]

This looks great, but I have a few questions if anyone knows the answers.

My first question is: how is this different from the treatment that was offered in Korea, which some members here tried?

The article mentions that the group that didn't receive the treatment also improved by, I think, 75%. How do they explain that?

Does anyone know where someone can try this treatment if they wanted to?

 

[withintention]

The difference appears to be the use of ultrasound to better target the stellate ganglion. I am not sure what treatment was offered in Korea. Can you provide a link?

Looking back through the forums, it seems that the few people who have tried this may not have received the injection from someone using ultrasound for guidance. That is the key point of this study — to demonstrate the benefits of using ultrasound to guide the injection.

I asked my doctor, and they said that pain specialists and anesthesiologists can offer this treatment. I am going to find one in my area and give it a try. I will report back after I do.

 

[Jammer]

I asked my doctor, and they said that pain specialists and anesthesiologists can offer this treatment. I am going to find one in my area and give it a try. I will report back after I do.

A short follow-up period of six days after treatment may not be sufficient to properly assess the long-term efficacy of ultrasound-guided stellate ganglion block for tinnitus.

It may be challenging to find a doctor who is willing to give it a try. Keep us updated if you find a doctor, along with the cost of treatment, whether it was done on both sides, and any long-term benefits you experience.

 

[Isabella 123]

What is the stellate ganglion? What does it mean to block it, and what does blocking it do? Thank you for any information!

 

[Joeseph Stope]

Ultrasound guided stellate ganglion block for the treatment of tinnitus - PubMed

BackgroundTinnitus, a common auditory disorder, significantly impacts patient quality of life and lacks universally effective treatments. The integration of advanced imaging technology like ultrasound in therapeutic interventions offers new possibilities in healthcare.ObjectiveThis study...

pubmed.ncbi.nlm.nih.gov

The effects are modest. It involved a moderately sized group. This is not the full paper, so it lacks detail.

The authors, specifically the research team, appear to be from China, Korea, or similar regions. I remember considering a treatment called "Ganglion Block" in the early nineties, during the early onset of my condition. If I recall correctly, the pioneers of this treatment were Dutch doctors. However, I was advised that it was somewhat dangerous and required a high level of precision to access the correct area.

Given that thirty years have passed since then, I am confident that the precision aspect has likely improved significantly with modern imaging technology. The fact that researchers are still exploring this approach suggests it may be more than just a speculative idea.

 

[AverageJoe12]

What is the stellate ganglion? What does it mean to block it, and what does blocking it do? Thank you for any information!

Google is your best bet here. The search results are helpful:

A stellate ganglion block is a medical procedure where a local anesthetic is injected near the stellate ganglion, a cluster of nerves in the neck.

SGB is primarily used to treat:

• Chronic pain, particularly in the upper extremities, head, and face
• Complex regional pain syndrome (CRPS)
• Post-traumatic stress disorder (PTSD)
• Vasomotor symptoms, such as hot flashes

 

[withintention]

I am not entirely sure what it is or what it does, but the study linked above suggests what blocking it might do for tinnitus sufferers.

I received a referral from my doctor for the procedure, but I have not gone through with it yet. I am still not entirely sure I will, as there is a chance of complications from the procedure.

My doctor referred me to a specialist at a clinic that focuses on pain medicine and physical rehabilitation. If anyone else gets a referral and tries it before I do, please share your experience here.

 

[ErikaS]

I had been looking into this for its potential use in treating PTSD, as it may help reset the nervous system and break the constant fight or flight cycle. After reviewing this study, I feel even more encouraged to pursue it. I am currently in the process of finding well-reviewed practitioners in my area who offer this treatment. I will share updates as I move forward.

 

[Dizzyhead888]

Where can we get this treatment?

 

[ErikaS]

After some tedious searching and making phone calls, I found a local doctor who is a board-certified neurologist with fellowship training in pain medicine and neurophysiology. He has a special interest in neurological disorders such as migraine, trigeminal neuralgia, and cluster headaches. He opened his own pain management center this past October.

He performs many procedures for pain management, including various nerve blocks and Botox. I was initially looking for someone who could perform the stellate ganglion block, but after reading his background, I decided to share everything about my tinnitus condition and see what he thought. He was very kind, knowledgeable, and empathetic, and he seemed genuinely intrigued by my symptoms.

He believes that tinnitus is closely tied to migraine processes and explained how the ears can be affected by a continuous migraine loop. He understood that I do not suffer from head pain migraines but still felt the migraine pathway was worth exploring. His suggested approach was to "work our way up" through different treatments to see if any would bring relief. His recommendation was: start with a CGRP inhibitor migraine medication, then try an occipital nerve block, followed by a stellate ganglion block, and finally consider Botox.

He gave me samples of Ubrelvy, a CGRP inhibitor similar to Nurtec. My ENT had given me Nurtec samples a few months ago, which had no effect, but I agreed to try Ubrelvy just to say we had covered that step. He also made it clear that he would never recommend first-generation migraine medications like Topiramate for my case, as he strongly believes they would worsen tinnitus. I found that especially interesting in light of the NeuroMed treatment.

I am not experiencing any improvement with Ubrelvy, so I am scheduled to return on the 12th for the occipital nerve blocks. His words to me were, "I will work with you if you work with me." I am very grateful to have found him, and even more grateful that he genuinely cares and is trying to help, rather than simply prescribing an SSRI or downplaying my experience.

I will post an update in the appropriate place regarding the occipital nerve block procedure. If we move forward with the stellate ganglion block, I will be sure to provide an update here.