Via Research Recognition Day Program VCOM-Carolinas 2025

Clinical Educational Research

Osteopathic Manipulative Treatment of the Sphenopalatine Ganglion for Induction of Lacrimation: A Pilot Study Kelsey Vineyard, MS 1 , Dr. David Redden, PhD 2 , Dr. Victoria Shadiack, DO 3 1. Edward Via College of Osteopathic Medicine, Spartanburg, SC. 2. . Edward Via College of Osteopathic Medicine, Clinical Affairs, Spartanburg, SC. 3. Edward Via College of Osteopathic Medicine, Biomedical Affairs and Research, Auburn, AL. Co-authorship should be given to collaborators such as a Statistician, who have made intellectual contribution in terms of writing, Mentor should be named last in list. Introduction Results Discussion

References • The treatment did not provide strong evidence of a meaningful change in tear production. • Net mean increase in tear production on Day 7 compared to baseline for both eyes. Limitations: • Small sample size relative to the variability in tear production. • OMT performed procedurally and not personalized to each subject as would normally be the case. • Possible variability in pressure during treatment. • Future studies should consider the use of pressure sensors to ensure consistent treatment technique. Conclusions Overall, though the results were limited by a small sample size and were not statistically significant, the improvement from baseline at the final time point may indicate viability of the concept and suggests the need for further studies. Future studies to consider: • Increased sample size • Additional soft tissue release techniques or parasympathetic nervous system activating OMT to increase potential effect Edward Via College of Osteopathic Medicine Institutional Review Board, IRB Record #2024-155, approved on October 8, 2024. Dr. David Redden, PhD, statistical analysis and data review. Acknowledgements 1. Sherman, Tatyana, Yasmin Qureshi, and Austin Bach. “Osteopathic Manipulative Treatment to Manage Ophthalmic Conditions.” Journal of Osteopathic Medicine 117, no. 9 (September 1, 2017): 568 – 75. https://doi.org/10.7556/jaoa.2017.111. 2. Stevens, Sue. “Schirmer’s Test.” Community Eye Health 24, no. 76 (December 2011): 45.

Dry eye is a commonly reported sensation and condition within the realm of ophthalmology for which there is no direct cure. Current treatments include: • Medicated eye drops • Thermal manipulation of tissues surrounding the glands • Neurostimulatory devices However, there currently exists no osteopathic manipulative treatment (OMT) for the condition of dry eyes. OMT is the manual manipulation of tissues to diagnose and treat somatic dysfunction within the body. The sphenopalatine ganglion as an OMT target: • Parasympathetic innervation of the lacrimal gland • Established intra-oral technique for stimulation/release Inclusion criteria: VCOM students, faculty, and staff. 18-45 years old Exclusion criteria : History of ocular surgery, diagnosis of dry eye syndrome, or TMJ disease. 18 individuals were recruited (n=18). The methods are as follows: • Baseline Schirmer test strip performed prior to OMT by placement of the paper lower lid bilaterally (OU) • Schirmer test was removed after 5 minutes and measured. • Sphenopalatine ganglion release OMT was performed by Dr. Shadiack bilaterally. • Subject was sat back up and new Schirmer tests were introduced OU and removed after 5 minutes. • Subjects returned 2- and 7-days post treatment for repeat Schirmer tests . Methods

Figure 3. Tear Production Over Time

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Day mean_right mean_left mean_sum

Tear Production (mm)

Table 1. P-values from Linear Mixed Model Analyses Day Right Left Sum 1 vs 0 0.808 0.813 0.781 2 vs 0 0.334 0.636 0.781 7 vs 0 0.141 0.443 0.197 • Compared to a Type I error rate, none of the p-values in Table 1 achieve statistical significance. Day Right Left Sum 1 vs 0 0.809 0.985 0.827 2 vs 0 0.427 0.622 0.621 7 vs 0 0.270 0.465 0.359 • Compared to a Type I error rate, none of the p-values in Table 2 achieve statistical significance. Table 2. P-values from a non-parametric approach, Wilcoxon Signed Rank. • Mean tear production measured at baseline (0), post-treatment (1), 2 days (2), and 7 days (7). • Mean tear production was highest on Day 7 regardless of eye.

Figure 2. Sphenopalatine Ganglion Release

Figure 1. Schirmer test

2025 Research Recognition Day

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