Stellate Ganglion Block as an Adjunctive Intervention for Chronic Subjective Tinnitus:Efficacy and Predictive Indicators
[Objective]To explore the efficacy and predictive indicators of stellate ganglion block(SGB)as an adjunc-tive intervention for chronic subjective tinnitus and accumulate experience for the application of SGB in the clinical treat-ment of tinnitus.[Methods]A retrospective review was conducted on the data of chronic subjective tinnitus patients who re-ceived SGB intervention,with unsatisfactory outcomes otherwise.Pure tone audiometry(PTA),tinnitus loudness evalua-tion and Pittsburgh sleep quality index(PSQI)were used.The tinnitus handicap inventory(THI)scores were compared before and after SGB intervention.Correlation analysis and linear regression equations were employed to identify the poten-tial indicators predicting the effectiveness of SGB intervention.Statistical analysis was performed by SPSS 24.0 software.[Results]By April 2023,a total of 107 patients with chronic subjective tinnitus had undergone SGB intervention,includ-ing 67 male and 40 female,with a mean age of(45.32±11.40)years old and an average tinnitus history of(20.32±24.64)months[16(12～20)].Only 7 patients(6.54%)quitted the intervention for personal reasons,which demonstrated good compliance with the intervention.No patients experienced adverse reactions such as infection at the injection site,hemato-ma,nerve injury,local anesthetic intoxication and so on,which revealed good safety.After SGB intervention,THI scores decreased to below 36 points in 77 patients and decrease by 10 points or more in 12 of the remaining patients,with a total effective rate of 89%.A paired sample t-test showed a significant difference in THI scores before and after SGB interven-tion(t=15.575,P<0.001),indicating good improvement.Pearson correlation analysis suggested that pre-intervention THI scores and subjective tinnitus loudness were significantly positively correlated with the improvement level of THI scores(P<0.05).Further stepwise linear regression analysis found that"pre-intervention THI scores"had statistical significance(P<0.001),with a regression coefficient of 0.308,predicting a 17.4%improvement level in THI scores.[Conclusions]Due to its good and safe short-term effects,SGB intervention can be used as a supplementary option for chronic subjective tin-nitus when other interventions are not ideal,especially for patients with higher THI scores.However,further research is needed to clarify the long-term efficacy and underlying mechanisms,in order to establish a more solid theoretical basis for SGB intervention in the treatment of subjective tinnitus.
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