In case of smell disorder, it is necessary to go to the otolaryngology department of the hospital for comprehensive examination and evaluation of nasal and intracranial disorders and treatment for the primary disease. The Department of Pain and Otolaryngology of Jiaxing First Hospital have teamed up to treat the causes of smell loss with cervical sympathetic nerve modulation technology and achieved good results.
What are the adverse effects of loss of sense of smell? Patients do not have any painful discomfort, it neither affects breathing, nor sleep, nor delays work, only that they cannot smell and eat at ordinary times, and there are few doctors and techniques specializing in the treatment of olfactory disorder, so most patients choose to give up the treatment. In fact, olfactory disorder can cause many disadvantages and even dangers to patients’ life, such as: ① delaying the treatment of the original disease that causes olfactory disorder; ② not being able to perceive the rotten food before eating; not being able to perceive the gas leak that causes poisoning, or burning vegetables that cause fire after forgetting to burn.
Why can cervical sympathetic modulation treat loss of sense of smell?
Sympathetic nerves are located in the lateral horn of the gray matter of the cervical 3 to lumbar 3 segments of the spinal cord. Sympathetic nerves innervate cardiovascular movement, glandular secretion, muscle tone, bronchial contraction and transmission of pain, and regulate the activities of the heart and other internal organs. The cervical sympathetic nerve has two sympathetic trunks located anterolateral to the cervical spine and posterior to the carotid sheath. There are usually three to four ganglia, namely the superior cervical ganglion, the middle and middle cervical ganglia, and the inferior cervical ganglion (the middle and middle cervical ganglia often have variations). Its distribution is extremely wide, not only to the blood vessels of the head, neck and upper extremities, sweat glands and erector spinae muscles, but also to the pharynx and heart, and branches to the pupillary opening muscles, oral glands, thyroid gland and glands of the nasal mucosa. The olfactory region of the nose (olfactory cells) is located in the mucosa of the upper turbinate and the upper part of the nasal septum.
Studies have shown that cervical sympathetic nerve block can normalize plant nerve function, endocrine function and immune function, while cardiovascular movement, glandular secretion, muscle tension, bronchial contraction and nociceptive conduction innervated by preganglionic and postganglionic fibers at the block site are also inhibited. Improve the abnormal blood rheological index, accelerate blood circulation, increase local oxygen content, and facilitate tissue repair. Thus, the function of olfactory cells in the nasal mucosa is also restored. Is cervical sympathetic nerve modulation technique a kind of surgery?
Cervical sympathetic nerve modulation technique is different from general surgery, it is essentially a nerve block technique. It is usually chosen to block the inferior cervical ganglion. The anterolateral approach puncture method, i.e., the paratracheal approach, is performed with a #5 to #7 needle with a perpendicular needle to the skin at about two transverse fingers above the sternoclavicular joint (cricoid cartilage plane equivalent to the transverse process of the 6th cervical vertebra) at the anterior border of the paraesophageal and sternocleidomastoid muscle. Generally, 7 to 10 ml of 0.4% lidocaine or 0.3% ropivacaine can be injected. 20 to 30 ml can be injected if the upper and middle cervical sympathetic nerves and the paraspinal sympathetic nerves of the 1st to 4th thoracic vertebrae are to be blocked at the same time.
What is the difference between cervical sympathetic nerve modulation technique and closure?
Some people may ask, “Isn’t cervical sympathetic modulation technique the same as a closed injection?” In fact, this is a misunderstanding. The international definition of nerve block therapy is to inject drugs into the spinal ganglion, plexus or nerve, sympathetic ganglion and other nerves, these drugs have the effect of regulating the nerves and dilating the microvasculature of the lesion, improving the blood circulation of the diseased tissue. Or, physical or chemical methods are used, or needles are pierced in the nerve to block the nerve conduction function. Chemical nerve blocks are mostly performed with low concentration of local anesthetics, but also with high concentration of local anesthetics, ethanol, phenol and other nerve-destroying drugs, thus achieving long-term analgesic effects.
Physical nerve blocks are commonly performed by thermal coagulation therapy, cryotherapy, and also by mechanical injury methods, such as facial nerve puncture compression for facial muscle spasm. “Closed therapy” is commonly known as “focal injection”, originated in the former Soviet Union, also known as procaine closed therapy, is to inject procaine into the body’s local pain points, like the Chinese medicine said “A is the point “The pain is injected there to play a temporary role in pain relief.
“Closure therapy” is generally used in the treatment of trauma, strain and degenerative osteoarthrosis of muscles, ligaments, fascia, tendon sheaths, bursae and bone fiber tubes. Because the “closed” injection contains prednisolone, dexamethasone and other hormone ingredients, long-term application of hormones prone to “bone brittle”, “face swelling”, endocrine disorders and other Complications caused by long-term application of large amounts of hormones are largely abandoned by pain physicians.
What should I do if I have nasal congestion and bilateral eye size after cervical sympathetic modulation?
The appearance of Horner’s syndrome is a sign of successful block, which is manifested by pupil narrowing, eyelid drooping, eye sunken, nasal congestion, conjunctival congestion, slight facial redness, no sweating, and warm feeling. Recovery is usually 30-60 minutes, so there is no need to worry.
VI. How much risk is there in cervical sympathetic nerve modulation technique for loss of smell? The distinctive feature of cervical sympathetic ganglion block is that it has a corrective effect on abnormal body functions, activates the body to maintain constant functions, and has a good effect on neurological, immune and endocrine functions. With the proper approach, cervical sympathetic ganglion block has almost no negative effects on the body, except for the slight pain during puncture. However, a variety of complications can occur due to the operation and medications. The top five of these are, in order, the recurrent laryngeal nerve block, local pain, brachial plexus block, cervical plexus nerve block, and hematoma due to penetration of a blood vessel.