Superior laryngeal nerve block for neurogenic cough: A case series

Vaninder K Dhillon, Vaninder K Dhillon

Abstract

Objectives: To demonstrate that an in-office superior laryngeal nerve (SLN) block with lidocaine and steroids is an effective alternative to neuromodulators for patients with neurogenic cough.

Study design: Retrospective study.

Methods: A retrospective review of 10 patients who underwent in office nerve block to the laryngeal nerve (SLN) for neurogenic cough. Demographic data and pre- and postcough survey index are the measure outcomes. Follow-up was 3-6 months.

Results: We find that all patients in this study that underwent an SLN block showed significant improvement in cough severity index (CSI). The average number of blocks was 2.3. The mean follow-up time from the first SLN block is 3.4 months. The mean CSI improvement 16.30. 95% confidence interval, 11.44-21.16; P < .0001. All patients in this study completed at least one session of cough suppression therapy with speech language pathology (SLP). No patients were on neuromodulators at the time of the SLN block.

Conclusions: There is a role for in-office SLN block with lidocaine and steroids for patients with neurogenic cough, and can be an effective alternative to neuromodulators.

Level of evidence: NA.

Keywords: Neurogenic cough; cough survey index; superior laryngeal nerve block.

Figures

Figure 1
Figure 1
Pre‐ and post‐treatment mean cough severity index scores for patients who underwent superior laryngeal nerve block for treatment of chronic cough.

References

    1. Altman KW, Noordzij JP, Rosen CA, Cohen S, Sulica L. Neurogenic cough. Laryngoscope 2015;125:1675–1681.
    1. Irwin RS, French CL, Chang A, et al. Classification of cough as a symptom in adults and management algorithms. Chest 2018;153(1):196–209.
    1. Lee B, Woo P. Chronic cough as a sign of laryngeal sensory neuropathy: diagnosis and treatment. Ann Otol Rhinol Laryngol 2005;114:253–257.
    1. Bastian RW, Vaidya AM, Delsupehe KG. Sensory neuropathic cough: a common and treatable cause of chronic cough. Otolaryngol Head Neck Surg 2006;135:17–21.
    1. Sulica L. The superior laryngeal nerve: function and dysfunction. Otolaryngol Clin North Am 2004;37:183–201.
    1. Vertigan AE, Theodoros DG, Gibson PG, Winkworth AL. Efficacy of speech pathology management for chronic cough: a randomized placebo controlled trial of treatment efficacy. Thorax 2006;61:1065–1069.
    1. Ryan NM, Vertigan AE, Bone S, Gibson PG. Cough reflex sensitivity improves with speech language pathology management of refractory chronic cough. Cough 2010;6:5.
    1. Nalamachu S, Morley‐Forster P. Diagnosing and managing postherpetic neuralgia. Drugs Aging 2012;29:863–869.
    1. Doyle DJ. Airway anesthesia: theory and practice. Anesthesiol Clin 2015;33(2):291–304.
    1. Simpson CB, Tibbetts KM, Loochtan MJ, Dominguez LM. Treatment of chronic neurogenic cough with in‐office superior laryngeal nerve block. Laryngoscope 2018;128:1898–1903.
    1. Shembel AC, Rosen CA, Zullo TG, Gartner‐Schmidt JL. Development and validation of the cough severity index: a severity index for chronic cough related to the upper airway. Laryngoscope 2013;123(8):1931–1936.
    1. Sasieta HC, Iyer VN, Orbelo DM, et al. Bilateral thyroarytenoid botulinum toxin type A injection for the treatment of refractory chronic cough. JAMA Otolaryngol Head Neck Surg 2016;142:881–888.
    1. Crawley BK, Murry T, Sulica L. Injection augmentation for chronic cough. J Voice 2015;29:763–767.
    1. Litts JK, Fink DS, Clary MS. The effect of vocal fold augmentation on cough symptoms in the presence of glottic insufficiency. Laryngoscope 2018. Jun;128(6):1316–1319.

Source: PubMed

3
구독하다