Can steroid and local anesthetic injection of the superior laryngeal nerve (SLN) produce subjective symptomatic improvements in patients with neurogenic cough?
Explore This IssueOctober 2023
Patients with neurogenic cough reported symptomatic improvement, and repeat injections may benefit patients with initial nonresponse.
BACKGROUND: Chronic cough with no clear etiology may lead to a diagnosis of neurogenic cough, which may be caused by hypersensitivity of the SLN’s internal branch. Current pharmacologic treatment options can cause intolerable side effects and be prohibitively expensive. Data on the recently emerged SLN block intervention appear promising.
STUDY DESIGN: Retrospective chart review.
SETTING: Department of Otolaryngology–Head and Neck Surgery, The Ohio State University College of Medicine, Columbus, Ohio.
SYNOPSIS: Researchers analyzed data on 54 patients who received SLN blocks at a single institution from January 2010 to June 2020. Subjects completed a Central Sensitization Inventory immediately prior to receiving an injection and again two weeks later, and also provided their subjective response. If partial or absent response to treatment was reported after two weeks, a second injection was offered. Results showed improvement endorsed by >70% of patients, 84% of them after one injection. Of patients whose first injection was ineffective, 40% reported a positive response to the second injection. All reported side effects were mild and included numbness or altered sensation in the thyrohyoid region immediately postinjection (31.5%) and transient throat pain at the injection site (7.4%). None of the symptoms traditionally associated with a neurogenic cough predicted a greater likelihood of improvement with the SLN block. Study limitations included its retrospective nature and a small cohort.
CITATION: Talbot N, Heller M, Nyirjesy S, et al. Superior laryngeal nerve block response rates in 54 neurogenic cough patients. Laryngoscope. 2023;133:2647–2653.