Superior laryngeal nerve transection for neuropathic cough: A pilot study

Area of Science:

• Otolaryngology
• Neurosurgery
• Pulmonology

Background:

• Neuropathic cough is a chronic condition often refractory to medical management.
• The internal branch of the superior laryngeal nerve (iSLN) plays a role in cough reflex sensitivity.

Purpose of the Study:

• To evaluate the efficacy and safety of surgical transection of the iSLN for medically refractory neuropathic cough.
• To describe a screening protocol to identify suitable candidates for iSLN transection.

Main Methods:

• Subjects with refractory neuropathic cough underwent iSLN nerve block with local anesthetic.
• Provocative testing and modified barium swallow studies (MBSS) were used for screening.
• Eligible subjects proceeded to operative iSLN transection, with outcomes retrospectively reviewed.

Main Results:

• Five out of six subjects experienced significant symptomatic relief after iSLN transection.
• Mean Cough Severity Index (CSI) scores decreased significantly post-operatively (34.83 to 15.5).
• No major complications or post-operative aspiration issues were reported.

Conclusions:

• iSLN transection is a viable surgical option for carefully selected patients with refractory neuropathic cough.
• The developed screening algorithm effectively identifies patients likely to benefit and confirms safe swallowing.