It is well known that chronic headaches are controled with Stellate Ganglion Block. Effectiveness of stellate ganglion block was examined retrospectively in various chronic headache. The headache classification and the patients number were followed. There were totally 3, 192 chronic headache patients in Kanto Teishin Hospital from 1970 to 1992. 427 were migraine: 514 tension type headache, 120 mixed type, 390 cluster headache, 104 atypical vascular headache, 93 cervical headache, 566 atypical facial pain, 139 temporomandibular dysfunction, 22 facial pain due to neoplasm, 22 psycogenic facial pain, 310 other symptomatic facial pain, 85 other symptomatic headache, 189 others, 182 headache not classifiable. Female patients were 1, 847 and male patients were 1, 345. This study excluded 3, 400 of trigeminal neuralgia that cloud not control with stellate ganglion block and 3, 300 of herpes zoster patients that was general disease. Patients were treated with stellate ganglion block one to two times a week, and were followed by questionnaire after 6 months of the last treatment. The follow up study showed that 43% of patients enjoyed headache free life without analgesics.
The effect of stellate ganglion block (SGB) on peripheral facial palsy were studied by comparing the results of electroneuronography (ENoG), palsy score (40-point scoring method) and the period from onset to initial block and recovery. The subjects were 114 patients with Bell's palsy and Hunt syndrome who were treated in our department within 14 days after onset. Of the 114 patients, 102 patients had a response to ENoG of 5% or greater and 97% among these caces revealed complete recovery. On the other hand, 12 patients had a response of 4% or less of normal and 67% of those showed unsatisfactory recovery of function. In addition, 8 patients had mild to moderate sequela. In conclusion, excellent therapeutic cure rate of facial palsy was obtained by SGB. More earlier treatment of SGB shortened the period of recovery and diminished the drop of ENoG value. From electrophysiological examination, it was suggested that SGB prevented the progress of the nerve degeneration and accelerated the recovery of injured nerve.
All cases of SHL visited in our hospital have been treated by the SGB since 1989 with the treatment of steroid, vitamins, vasodilatators and oxygenation. The authors investigated the effectiveness of SGB (SGB group: 112 cases in 1989-1993) compared with medical treatment (Control group: 28 cases in 1988-1989), and analyzed the prognostic indicators related to recovery. According to the recovery criteria decided by the official committee of SHL in Japan, all evaluated data were calculated for the complete recovery rate (cases of cure or complete return to <20dB in all tested frequencies-(1)), the recovery rate ((1) and cases of remarcable return to average pure tone score of >30dB-(2)), the effective rate ((2) and cases of return to average pure tone score of >10dB) and ineffective rate. The complete recovery rate was 18.7% in SGB group, 10.7% in control group, the recovery rate was 60.7% (SGB), 50.0% (control) and the effective rate was 83.9% (SGB), 64.2% (control). The significant difference was found between two groups in the effective rate (p<0.05). Poorer prognosis on the recovery rate were found in the groups of high age, downsloping type or profound type of audiogram, delayed initiation of therapies and vertigo. On the other hand, SGB group had higher effective rate in such poorer prognostic groups and 61% of cases in ineffective group showed the improvement of subjective symptoms. The conclusion in this study is that SGB is thought to be a useful therapy for SHL, as it may increase the blood supply to the cochlear.
The effects of weekly repeated stellate ganglion block (SGB) on the condition of 11 stable bronchial asthmatics (7 women and 4 men, aged between 40 and 63, mean 53.9) were studied. The 7 parameters adopted for assessment of the effects of SGB were as follows: 1) provisional respiratory function; 2) ventilatory function; 3) ventilatory response to carbon dioxide; 4) serum levels of chemical mediators; 5) state of the autonomic nervous system; 6) number of necessary intravenous injections of aminophylline; 7) patients' subjective assessment of their general condition. The results of repeated SGB were interpreted as follows: 1) respiratory resistance was decreased; 2) no adverse effects on SpO2, ETCO2, tidal volume, V1.0%, minute volume and respiration rate were associated with the treatment; 3) ventilatory response to carbon dioxide under the conditions of 59-93% oxygen concentration was not impaired; 4) decreased serum levels of LTB4, LTC4 and histamine indicated possible reduction of bronchial hypersensitivity; 5) enhanced regulation of the autonomic nervous system was achieved; 6) occasions requiring aminophylline infusion therapy were reduced; 7) patients' subjective comments. In conclusion, in terms of the parameters analyzed in the present study, repeated SGB can be recommended as an adjunctive approach to control of bronchial asthma.
Is stellate ganglion block (SGB) really useful for the therapy of ocular diseases? In order to answer this question, SGB has been applied to the cases which couldn't be recovered by general methods. As a result, the following five ocular diseases were thought to be good indications for SGB. 1) Prolonged post-operative ocular pain 16 cases were treated by SGB. 6 cases were deafferentation pain. SGB was effective in 4 of 6 cases. 10 cases were non-deafferentation pain. SGB was very effective in all of them. 2) Scleritis SGB was applied to 6 cases. All of them were recovered by SGB. 3) Central retinal artery occulusion In 10 of 15 cases, visual acuity improved. The improvement was caused by the decrease of macular edema. 4) Cystoid macular edema after cataract surgery 35 cases were treated by SGB. All of them got improved visual acuity. 5) Central exudative chorioretinopathy In 34 of 43 cases which were treated by SGB, visual acuity improved. On the other hand, in 22 cases of the non-SGB control group, visual acuity improved in only 6 cases.