Journal article
Indications and Short-Term Outcomes for In-Office Therapeutic Superior Laryngeal Nerve Block
Annals of otology, rhinology & laryngology, Vol.133(2), pp.174-180
02/2024
DOI: 10.1177/00034894231194384
PMCID: PMC10771019
PMID: 37608685
Abstract
OBJECTIVE Superior laryngeal nerve (SLN) block consists of injection of steroid and anesthetic at the internal branch of the SLN entry site. Prior case series have demonstrated beneficial effects on neurogenic cough. SLN blocks have also recently shown benefit for paralaryngeal pain. We describe short-term outcomes for multiple symptoms of irritable larynx syndrome (ILS) including neurogenic cough, dysphonia related to laryngeal hypersensitivity, inducible laryngeal obstruction (ILO), paralaryngeal pain, and isolated globus. METHODS Retrospective review from 2 institutions of patients undergoing a single SLN block for the indications listed. Variables include age, sex, indication(s), known vagus neuropathy, and patient-reported outcomes at short-term follow-up. RESULTS A total of 209 patients were included (59 males, 150 females; age: 58 ± 13 years). Twenty-six patients (12%) had a history of a vagus nerve injury. Indications included neurogenic cough (n = 149), dysphonia related to laryngeal hypersensitivity (n = 66), paralaryngeal pain (n = 50), ILO (n = 23), and isolated globus (n = 3). Some patients had multiple indications. Significant improvements in patient-reported measures occurred after a single SLN block within 2 to 4 weeks for neurogenic cough (cough severity index; 25.2 ± 11.2 to 19.0 ± 12.8; P < .001), dysphonia (voice handicap index-10; 22.1 ± 12.2-18.0 ± 13.3; P = .005), and ILO (dyspnea index; 21.0 ± 14.9-14.7 ± 15.7; P = .017). Subjective pain improved in 23 of 39 patients with paralaryngeal pain. There was no observed improvement for isolated globus. Presence of known vagal neuropathy or therapy around the time of SLN block did not affect outcome. CONCLUSION SLN block can be an effective component of treatment for a variety of ILS symptoms. Patients may experience some improvement after 1 injection. LAY SUMMARY Symptoms of irritable larynx syndrome, such as neurogenic cough, paralaryngeal pain, inducible laryngeal obstruction, and dysphonia related to laryngeal hypersensitivity can be challenging to manage. In-office Superior Laryngeal Nerve blocks can serve as a quick, well tolerated, adjunctive treatment with positive short-term outcomes. LEVEL OF EVIDENCE4.
Details
- Title: Subtitle
- Indications and Short-Term Outcomes for In-Office Therapeutic Superior Laryngeal Nerve Block
- Creators
- Alan J GrayMatthew R Hoffman - University of IowaZao M YangBeau Vandiver - University of Alabama at BirminghamJoshua Purvis - University of Alabama at BirminghamJake P Morgan - University of Alabama at BirminghamEdie R Hapner - University of Alabama at BirminghamLaura Dominguez - Cleveland Clinic FloridaKathleen Tibbetts - The University of Texas Southwestern Medical CenterC Blake Simpson - University of Alabama at Birmingham
- Resource Type
- Journal article
- Publication Details
- Annals of otology, rhinology & laryngology, Vol.133(2), pp.174-180
- DOI
- 10.1177/00034894231194384
- PMID
- 37608685
- PMCID
- PMC10771019
- NLM abbreviation
- Ann Otol Rhinol Laryngol
- ISSN
- 0003-4894
- eISSN
- 1943-572X
- Language
- English
- Electronic publication date
- 08/22/2023
- Date published
- 02/2024
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984455948202771
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