Abstract
PURPOSE: This systematic review and meta-analysis evaluates the effectiveness and safety of stellate ganglion block (SGB) for tinnitus. METHODS: A comprehensive systematic literature search was performed across four Chinese databases include China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), and SinoMed. five English databases include PubMed, Cochrane Library, Embase, Ovid, and Web of Science to identify randomized controlled trials (RCTs) investigating the use of SGB for tinnitus treatment published before November 28, 2025. Searches were conducted in both Chinese and English. Following a rigorous screening process, meta-analyses were carried out using Stata 17.0 and RevMan 5.2.1 software. The study protocol was registered on PROSPERO (CRD420251242113). RESULTS: A total of 11 randomized controlled trials comprising 915 patients were included in this study. Meta-analysis demonstrated that SGB combined other therapy was significantly more effective than the control group in treating tinnitus, with an overall effective rate (OR = 4.53, 95% CI [3.15, 6.53], p < 0.00001). In terms of functional improvement, SGB significantly reduced the THI (MD = -5.73, 95% CI [-6.10, -5.36], p < 0.00001) and the SAS (MD = -11.37, 95% CI [-12.46, -10.29], p < 0.00001). Hemodynamic assessments revealed a notable increase in basilar artery blood flow velocity following SGB treatment (Vs: MD = 5.60 cm/s, 95% CI [4.40, 6.80], p < 0.00001; Vd: MD = 4.26 cm/s, 95% CI [3.70, 4.83], p < 0.00001). Similarly, carotid artery blood flow velocity showed significant improvement (PSV: MD = 4.73 cm/s, 95% CI [3.26, 6.18], p < 0.00001; EDV: MD = 10.85 cm/s, 95% CI [6.02, 15.68], p < 0.0001). CONCLUSION: SGB combination therapy shows promise in managing tinnitus by improving effective rates, blood flow, THI and SAS scores. However, future large-scale, rigorous trials are essential to standardize treatment, address potential bias, and confirm long-term benefits. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO, identifier CRD420251242113.