Campagnolo Andrea, Nickel Vinícius, Benninger Michael S
Department of Otolaryngology-Head and Neck Surgery, State University of Rio de Janeiro, Av. Vinte e Oito de Setembro 77, Rio de Janeiro, RJ, 20551-900, Brazil.
Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic Lerner College of Medicine, Head and Neck Institute, The Cleveland Clinic, 9500, Euclid Ave. A-71, Cleveland, OH, 44195, USA.
Lung. 2025 May 22;203(1):63. doi: 10.1007/s00408-025-00819-1.
To systematically review the efficacy and safety, both short and long-term, of superior laryngeal nerve block (SLNB) for managing neuropathic cough.
A literature search was conducted using the keywords "Superior laryngeal nerve block," "Neurogenic Cough," "Neuropathic Cough," and "Refractory Chronic Cough." The primary outcome was cough-specific quality of life (QoL), evaluated with validated patient-reported outcome measures (PROMs) such as the Leicester Cough Questionnaire (LCQ), Cough Severity Index (CSI), and Hull Airway Reflux Questionnaire (HARQ). Additional data included SLNB technique, cough duration, use of neuromodulators and Behavioral Cough Suppression Therapy (BCST), injection frequency, vocal fold dysfunction (VFD), and adverse events. Quality assessments used the Methodological Index for Non-Randomized Studies (MINORS) criteria.
Ten studies comprising 625 patients were included. The average cough duration prior to intervention was 78 months, with a mean follow-up of 5.01 months. Patients received an average of 2.5 injections. Short-term outcomes showed consistent improvements in PROMs and cough perception. Long-term outcomes (beyond three months) were reported in four studies, with minimal variations but no statistical comparisons to baseline scores. Significant heterogeneity was noted across studies, including differences in assessment protocols and adjunctive therapies. No significant adverse events were reported.
SLNB is a safe and effective treatment for refractory chronic cough, either alone or with systemic medications. However, the variability among studies highlights the need for standardized protocols and further research with long-term follow-up to confirm its efficacy.
系统评价喉上神经阻滞（SLNB）治疗神经性咳嗽的短期和长期疗效及安全性。
使用关键词“喉上神经阻滞”“神经源性咳嗽”“神经性咳嗽”和“难治性慢性咳嗽”进行文献检索。主要结局是咳嗽特异性生活质量（QoL），采用经过验证的患者报告结局测量指标（PROMs）进行评估，如莱斯特咳嗽问卷（LCQ）、咳嗽严重程度指数（CSI）和赫尔气道反流问卷（HARQ）。其他数据包括SLNB技术、咳嗽持续时间、神经调节剂和行为性咳嗽抑制疗法（BCST）的使用、注射频率、声带功能障碍（VFD）和不良事件。质量评估采用非随机研究方法学指数（MINORS）标准。
纳入10项研究，共625例患者。干预前平均咳嗽持续时间为78个月，平均随访5.01个月。患者平均接受2.5次注射。短期结局显示PROMs和咳嗽感知持续改善。四项研究报告了长期结局（三个月后），变化最小，但未与基线评分进行统计学比较。各研究间存在显著异质性，包括评估方案和辅助治疗的差异。未报告重大不良事件。
SLNB单独或与全身用药联合使用时，是治疗难治性慢性咳嗽的一种安全有效的方法。然而，研究之间的差异突出表明需要标准化方案，并进行长期随访的进一步研究以确认其疗效。
