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Visual Instillation of Sphenopalatine-block Intervention for ONgoing Migraine (VISION)

4 listopada 2026 zaktualizowane przez: Association of Migraine Disorders

The goal of this double-blinded, randomized placebo controlled clinical trial is to to see if using a numbing medicine (lidocaine) on certain areas inside the nose can help with headaches, neck pain, facial pain and pressure, and other symptoms. It also aims to understand the pathophysiology that causes these symptoms.

The main questions it aims to answer are:

  1. Is applying numbing medication directly to the sphenopalatine ganglion (SPG) area, while watching through the scope to make sure it's in the right place, a workable and effective way to treat migraine headaches immediately and 24 hours?
  2. Is applying numbing medication directly to the sphenopalatine ganglion (SPG) area, while watching through the scope to make sure it's in the right place, a workable and effective way to improve patient-reported outcomes?
  3. Does daily lidocaine nasal spray improve patient-reported outcomes?

The 3-month study requires:

  • One virtual visit (on the computer)
  • One visit to the office for placement of the numbing medicine under direct vision
  • One week of daily nasal spray treatment
  • Daily headache diary entries that take less than two minutes to complete

Przegląd badań

Status

Jeszcze nie rekrutacja

Warunki

Interwencja / Leczenie

Typ studiów

Interwencyjne

Zapisy (Szacowany)

74

Faza

  • Faza 2

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Lokalizacje studiów

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat i starsze (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion criteria:

  • Aged 18 years or older

  • Any race

  • Any gender

  • At least 2 of 3 positives (a, b, c) below on the ID Migraine Screener from the American Headache Society:

    1. Photophobia
    2. Inability to function
    3. Nausea
  • At least 3 months of patient-reported episodic or persistent discomfort, pain, or pressure in the anatomic distribution of the paranasal sinuses, orbits, or nasal cavities.

  • The patient experiences at least 10 days of headaches and/or FPP within a 30-day period, during the run-in phase.

  • No evidence of abnormal sinus findings on imaging [paranasal sinus CT, including cone beam imaging, or MRI (MRI images must include all paranasal sinuses) obtained when symptomatic in the last 12 months prior to presentation. Normal imaging findings included isolated mucus retention cysts 2 cm or less in size and minimal non-circumferential (isolated areas) mucosal thickening (3mm or less).

  • Normal endoscopy if performed prior to enrollment, defined as the absence of purulent (opaque - white or other discolored - secretions) at the middle meatus or sphenoethmoid recess or nasal polyp disease.

  • Daily access to a cell phone that can function with the study mobile application

  • For women of child bearing potential: not pregnant and using a method of contraception during the duration of the study.

  • The patient can be taking interventional and preventive medications and other treatments before and during the study period, including new medications which will be tracked. The clinical coordinator will ask the patient to refrain from taking any abortive medication, cannabis, and psilocybin 24 hours prior to the procedure visit.

Exclusion criteria:

  • Prior endoscopic sinus surgery within the 3 months prior to enrollment.
  • Nasal endoscopy if performed prior to enrollment shows severe signs of mucosal infection, (mucopurulent drainage) or nasal polyposis.
  • A history of anterior skull base neoplasia.
  • Nasal endoscopy if performed prior to enrollment does not allow visualization of the middle turbinate on endoscopy bilaterally after application of a topical decongestant.
  • Signs of active or chronic sinusitis on CT (>3mm mucosal thickening or air fluid level in any paranasal sinus.)
  • The patient cannot tolerate the use of topical anesthetics or intranasal endoscopy without sedation or general anesthesia
  • Unable to see the middle meatus with either a nasal speculum or an endoscope
  • Allergy to lidocaine or other local anesthetics (tertiary amine class 1b).
  • Is currently using a schedule II narcotic for migraine pain.
  • Current cocaine use or cocaine use within the last 30 days.
  • Currently immunocompromised
  • History or evidence of any other unstable or clinically significant medical condition that in the opinion of the sponsor-investigator/ Principal Investigator, would pose a risk to subject safety or interfere with the study evaluation, procedures or completion.
  • Has received any investigational agent within 30 days of enrollment.
  • Plans to participate in a concurrent clinical trial.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Potroić

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Topical lidocaine endoscopically-guided intranasal nerve block

Topical solution of 4% lidocaine on small cotton pledgets with be placed endoscopically at the posterior root of the middle turbinate and in the anterior ethmoid nerve region bilaterally for Sphenopalatine Ganglion Block (SPG) block with anterior ethmoid (AE) block.

A rigid endoscopic technique utilizing a cotton pledget as a delivery vehicle of the topical lidocaine allows direct visualization of the target.

Komparator placebo: Placebo (saline) endoscopically-guided intranasal nerve block

Topical solution of saline on small cotton pledgets with be placed endoscopically at the posterior root of the middle turbinate and in the anterior ethmoid nerve region bilaterally for Sphenopalatine Ganglion Block (SPG) block with anterior ethmoid (AE) block.

A rigid endoscopic technique utilizing cotton pledget as a delivery vehicle of the topical saline allows direct visualization of the target.

Eksperymentalny: Nasal spray with lidocaine

This treatment arm will be 4% lidocaine solution in a metered bottle. The Pump size is 0.1 mL per spray dispenses 4 mg of lidocaine per spray - total of 16 mg (vol 0.4 mL). Participants will be instructed to use 2 sprays in each nostril per 24 hours.

A rigid endoscopic technique utilizing a cotton pledget as a delivery vehicle of the topical lidocaine allows direct visualization of the target.

Komparator placebo: Nasal spray with Saline (Placebo)

This treatment arm will be saline solution in a metered bottle. The Pump size is 0.1 mL per spray dispenses 4 mg of saline per spray - total of 16 mg (vol 0.4 mL). Participants will be instructed to use 2 sprays in each nostril per 24 hours.

A rigid endoscopic technique utilizing cotton pledget as a delivery vehicle of the topical saline allows direct visualization of the target.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Acute headache pain
Ramy czasowe: Immediately before (pre-treatment) and after the endoscopy procedure at Visit 2, approximately 1 month after enrollment.

Acute headache pain will be measured using a 0 to 10 Likert scale (0 representing No Pain, and 10 representing the worst pain possible), before (pre-treatment) and after the endoscopy procedure (post-treatment) at 15, 30, 60 min and 24 hours.

Immediately before (pre-treatment) and after the endoscopy procedure at Visit 2, approximately 1 month after enrollment.
Acute facial pain or pressure
Ramy czasowe: Immediately before (pre-treatment) and after the endoscopy procedure at Visit 2, approximately 1 month after enrollment.

Acute facial pain or pressure will be measured using a 0 to 10 Likert scale (0 representing No Pain, and 10 representing the worst pain possible), before (pre-treatment) and after the endoscopy procedure (post-treatment) at 15, 30, 60 min and 24 hours.

Immediately before (pre-treatment) and after the endoscopy procedure at Visit 2, approximately 1 month after enrollment.
Acute neck pain
Ramy czasowe: Immediately before (pre-treatment) and after the endoscopy procedure at Visit 2, approximately 1 month after enrollment.

Acute neck pain will be measured using a 0 to 10 Likert scale (0 representing No Pain, and 10 representing the worst pain possible), before (pre-treatment) and after the endoscopy procedure (post-treatment) at 15, 30, 60 min and 24 hours.

Immediately before (pre-treatment) and after the endoscopy procedure at Visit 2, approximately 1 month after enrollment.

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Headache days per month
Ramy czasowe: Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.

Daily headache pain recorded in a mobile application. Recorded as binary (Yes/No) and rated using a 0 to 10 Likert scale (0 representing No Pain, and 10 representing the worst pain possible).

Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.
Facial pain or pressure days per month
Ramy czasowe: Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.

Daily facial pain or pressure recorded in a mobile application. Recorded as binary (Yes/No) and rated using a 0 to 10 Likert scale (0 representing No Pain or pressure, and 10 representing the worst pain or pressure possible).

Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.
Neck pain days per month
Ramy czasowe: Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.

Daily neck pain recorded in a mobile application. Recorded as binary (Yes/No) and rated using a 0 to 10 Likert scale (0 representing No Pain, and 10 representing the worst pain possible).

Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.
Sinonasal Outcome Test- 22 (SNOT-22)
Ramy czasowe: Immediately before the treatment at 1 month and again 1 month after the endoscopy procedure, and again 1 month after the nasal spray treatment.

SNOT-22 is A validated 22-item questionnaire that measures the health-related quality of life (HRQoL) of patients with chronic rhinosinusitis (CRS). The SNOT-22 is scored by adding the individual values of 22 symptom and quality-of-life items. Each item is graded on a scale from 0 to 5, yielding a total cumulative score between 0 and 110, where higher numbers reflect more severe symptoms and a greater impact on health.

Immediately before the treatment at 1 month and again 1 month after the endoscopy procedure, and again 1 month after the nasal spray treatment.
Migraine Disability Assessment (MIDAS)
Ramy czasowe: Immediately before the treatment at 1 month and again 1 month after the endoscopy procedure, and again 1 month after the nasal spray treatment.

MIDAS is a valid and reliable short questionnaire for assessment of headache related disability. Respondents will enter the total number of days affected in the last one month for:

Work or school: Days missed. Work or school productivity: Days where productivity was reduced by half or more.

Household work: Days missed. Household work productivity: Days where productivity was reduced by half or more.

Family, social, or leisure activities: Days missed.

Immediately before the treatment at 1 month and again 1 month after the endoscopy procedure, and again 1 month after the nasal spray treatment.

Inne miary wyników

Miara wyniku
Opis środka
Ramy czasowe
Additional headache symptoms
Ramy czasowe: Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.

Additional headache symptoms recorded in a mobile application. Recorded as binary (Yes/No) and rated using a 0 to 10 Likert scale (0 representing No Pain, and 10 representing the worst pain possible).

Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.
Rescue medications
Ramy czasowe: Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.

Rescue medication needed, recorded in a mobile application. Recorded as binary (Yes/No).

Daily, following enrollment to right before the block treatment at 1 month and again from right after the treatment to 1 month after treatment. During nasal spray treatment (1 week) and 30 days following spray treatment.

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Śledczy

  • Główny śledczy: Jerry Schreibstein, MD, Ear, Nose, & Throat Surgeons of Western New England

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

1 stycznia 2027

Zakończenie podstawowe (Szacowany)

1 września 2028

Ukończenie studiów (Szacowany)

1 stycznia 2029

Daty rejestracji na studia

Pierwszy przesłany

1 sierpnia 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

10 sierpnia 2026

Pierwszy wysłany (Rzeczywisty)

14 sierpnia 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

9 listopada 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

4 listopada 2026

Ostatnia weryfikacja

1 listopada 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • VISION Study

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Tak

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .