Department of Otolaryngology-Head and Neck Surgery, University of Texas Health San Antonio, San Antonio, TX, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Alabama-Birmingham, Birmingham, AL, USA.
Ann Otol Rhinol Laryngol. 2024 Feb;133(2):174-180. doi: 10.1177/00034894231194384. Epub 2023 Aug 22.
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.
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.
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; < .001), dysphonia (voice handicap index-10; 22.1 ± 12.2-18.0 ± 13.3; = .005), and ILO (dyspnea index; 21.0 ± 14.9-14.7 ± 15.7; = .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.
SLN block can be an effective component of treatment for a variety of ILS symptoms. Patients may experience some improvement after 1 injection.
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.
喉上神经（SLN）阻滞包括在 SLN 进入部位的内支注射类固醇和麻醉剂。先前的病例系列研究表明，该方法对神经性咳嗽有有益效果。SLN 阻滞最近也显示出对喉旁疼痛有益。我们描述了包括神经性咳嗽、与喉高敏相关的发声障碍、诱导性喉阻塞（ILO）、喉旁疼痛和孤立性球在内的多种喉易激综合征（ILS）症状的短期治疗结果。
对 2 家机构接受单一 SLN 阻滞治疗的患者进行回顾性分析，适应证包括所列内容。变量包括年龄、性别、适应证、已知迷走神经病变和短期随访时的患者报告结果。
共纳入 209 例患者（男性 59 例，女性 150 例；年龄：58±13 岁）。26 例（12%）有迷走神经损伤史。适应证包括神经性咳嗽（n=149）、与喉高敏相关的发声障碍（n=66）、喉旁疼痛（n=50）、ILO（n=23）和孤立性球（n=3）。一些患者有多种适应证。在 2 至 4 周内，单次 SLN 阻滞后，患者报告的测量值在以下方面有显著改善：神经性咳嗽（咳嗽严重指数；25.2±11.2 至 19.0±12.8； < .001）、发声障碍（嗓音障碍指数-10；22.1±12.2 至 18.0±13.3； = .005）和 ILO（呼吸困难指数；21.0±14.9 至 14.7±15.7； = .017）。39 例喉旁疼痛患者中有 23 例主观疼痛改善。孤立性球的情况未见改善。存在已知的迷走神经病变或 SLN 阻滞治疗前后的治疗情况并不影响结果。
SLN 阻滞可以作为治疗多种 ILS 症状的有效方法。患者在接受 1 次注射后可能会有所改善。
喉易激综合征的症状，如神经性咳嗽、喉旁疼痛、诱导性喉阻塞和与喉高敏相关的发声障碍，可能难以治疗。门诊喉上神经阻滞可以作为一种快速、耐受良好的辅助治疗方法，具有良好的短期疗效。
4 级
