{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T01:50:31Z","timestamp":1783389031617,"version":"3.54.6"},"reference-count":31,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"abstract":"Importance<\/jats:title>Smell distortion (parosmia) is a symptom of post\u2013COVID-19 condition that persists and has immeasurable detriments on quality of life. To date, a standard criterion for treatment of this bothersome condition has not been identified.<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine whether stellate ganglion block (SGB) is effective and safe in improving olfactory dysfunction in patients with persistent COVID-19\u2212induced parosmia.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This was a randomized, double-blinded, placebo-controlled clinical trial conducted from October 2023 to September 2024 at a single center study (the Washington University in St Louis\/Barnes Jewish Hospital). A volunteer sample of 192 individuals were screened; 57 were enrolled after meeting eligibility criteria (age 18-70 years with self-reported parosmia of \u22656 months since COVID-19 infection, and a screening score of \u226540 on the Parosmia Olfactory Dysfunction Outcomes Rating [DisODOR] scale). Of 135 excluded, the most common reasons were prior SGB (n\u2009=\u200942) and parosmia resolution or non\u2212COVID-19\u2212induced parosmia (n\u2009=\u200928). Data were analyzed from September to October 2024.<\/jats:p><\/jats:sec>Intervention<\/jats:title>Ultrasonography-guided injection of 6 to 8 mL of active mepivacaine, 1%, or saline, 0.9%, at the right or left (randomized 1:1) stellate ganglion was performed by a board-certified anesthesiologist and pain medicine specialist.<\/jats:p><\/jats:sec>Main Outcome and Measure<\/jats:title>Between-subject difference of 25% in proportion of responders (defined by a 15-point decrease in DisODOR score) from baseline.<\/jats:p><\/jats:sec>Results<\/jats:title>The study evaluated 48 participants, 32 randomized to SGB (median [range] age, 45 [19-64] y; 25 [81%] female), and 16 to placebo (median [SD] age, 45 [26-64] y; 13 [81%] female). Time since COVID-19 infection was similar between groups (SGB, 35.3 vs placebo, 30.6 months; MD\u2009=\u2009\u22123.1 months; 95% CI, \u221210.9 to 3.7). Three-month response rate was 43% (n\u2009=\u200913) for SGB and 38% (n\u2009=\u20096) for placebo (difference, \u22125%; 95% CI, \u221232% to 33%). There was no between-group difference in clinical global impression of improvement.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This randomized clinical trial found that SGB is not superior to placebo in treating COVID-19\u2212induced parosmia, and thus, should not be recommended as treatment.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT06253806<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2025.1304","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T15:01:01Z","timestamp":1749740461000},"source":"Crossref","is-referenced-by-count":8,"title":["Stellate Ganglion Block for the Treatment of COVID-19\u2212Induced Parosmia"],"prefix":"10.1001","author":[{"given":"Nyssa Fox","family":"Farrell","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine, St Louis, 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