Indications and Short-Term Outcomes for In-Office Therapeutic Superior Laryngeal Nerve Block

Area of Science:

• Otolaryngology
• Neurology
• Pain Management

Background:

• Irritable Larynx Syndrome (ILS) encompasses diverse symptoms including neurogenic cough, dysphonia, inducible laryngeal obstruction (ILO), and paralaryngeal pain.
• Conventional treatments for ILS can be challenging, necessitating exploration of novel therapeutic approaches.
• Superior Laryngeal Nerve (SLN) blocks have shown promise for specific ILS symptoms like neurogenic cough and paralaryngeal pain.

Purpose of the Study:

• To evaluate the short-term efficacy of a single Superior Laryngeal Nerve (SLN) block for multiple symptoms of Irritable Larynx Syndrome (ILS).
• To assess patient-reported outcomes for neurogenic cough, dysphonia, inducible laryngeal obstruction (ILO), paralaryngeal pain, and isolated globus following SLN block.

Main Methods:

• Retrospective review of 209 patients who received a single SLN block across two institutions.
• Data collected included patient demographics, indications for the block, history of vagus neuropathy, and short-term patient-reported outcomes.
• Symptoms assessed included neurogenic cough, dysphonia, ILO, paralaryngeal pain, and isolated globus.

Main Results:

• Significant improvements were observed in neurogenic cough (Cough Severity Index), dysphonia (Voice Handicap Index-10), and ILO (Dyspnea Index) within 2-4 weeks post-SLN block (P < .05 for all).
• Subjective pain relief was reported by 23 of 39 patients with paralaryngeal pain.
• No significant improvement was noted for isolated globus, and prior vagal neuropathy did not impact outcomes.

Conclusions:

• Superior Laryngeal Nerve (SLN) block is an effective adjunctive treatment for various Irritable Larynx Syndrome (ILS) symptoms.
• A single in-office SLN block provides rapid, well-tolerated, and positive short-term outcomes for conditions like neurogenic cough, dysphonia, and ILO.
• SLN block represents a promising therapeutic option for managing challenging ILS symptoms.