Superior laryngeal nerve block for neurogenic cough: A case series

Abstract

Objectives To demonstrate that an in‐office superior laryngeal nerve (SLN) block with lidocaine and steroids is an effective alternative to neuromodulators for patients with neurogenic cough. Study Design Retrospective study. Methods A retrospective review of 10 patients who underwent in office nerve block to the laryngeal nerve (SLN) for neurogenic cough. Demographic data and pre‐ and postcough survey index are the measure outcomes. Follow‐up was 3–6 months. Results We find that all patients in this study that underwent an SLN block showed significant improvement in cough severity index (CSI). The average number of blocks was 2.3. The mean follow‐up time from the first SLN block is 3.4 months. The mean CSI improvement 16.30. 95% confidence interval, 11.44–21.16; P < .0001. All patients in this study completed at least one session of cough suppression therapy with speech language pathology (SLP). No patients were on neuromodulators at the time of the SLN block. Conclusions There is a role for in‐office SLN block with lidocaine and steroids for patients with neurogenic cough, and can be an effective alternative to neuromodulators. Level of Evidence NA

Curbing the Cough: Multimodal Treatments for Neurogenic Cough: A Systematic Review and Meta‐Analysis

“…Thirty‐seven articles 2,7,11–13,19,21–23,25,29–33,35–44,46–51,54,55,57,58,60,63 had sufficient information to perform meta‐analysis (Figure 1). There were 30 RCTs 7,19,20,22,23,25–28,30,32,34–37,39,40,42–45,48,50,51,53,56,57,59,62,64 (including three unpublished completed clinical trials 20,27,34 ), 10 retrospective case series, 2,11–13,31,46,49,55,58,63 nine prospective case series, 21,29,33,38,47,52,54,60,61 one prospective cohort study, 24 and one retrospective cohort study 41 . For studies that produced more than one manuscript, each article was assessed for unique patient data 28,40,53,64 …”

“…Twenty‐one observational studies 2,11–13,21,24,29,31,33,38,41,46,47,49,52,54,55,58,60,61,63 were assessed with the MINORS criteria (Supporting Information 2 ) . Eighteen non‐comparative studies 2,11–13,21,29,31,33,38,46,47,49,54,55,58,60,61,63 had sum scores in the middle‐to‐higher range (7–14) and three comparative studies 24,41,52 had sum scores in the middle‐range (14–16). Most of the RCTs 7,19,20,22,25‐28,30,32,34‐37,39,40,42‐45,48,50,51,53,56,57,59,62,64 assessed with the RoB 2 ranged from some to high concern for bias; only one RCT 23 had low concern for bias (Supporting Information 3).…”

“…For example, 24 unique terms labeled the condition; the most common was “chronic cough” (10 studies). Two studies used the term “NC,” 12,29 one study used “neurogenic chronic cough,” 58 and one study used “chronic neurogenic cough.” 11 Furthermore, only three studies reported using CHEST guidelines to diagnose patients 12,24,48 …”

“…Among the studies of procedural therapy, there was a median of one treatment. Specifically for SLN block, the mean number of treatments was 2.3 11 and 2.4 46 injections.…”

Longitudinal Follow‐up of Superior Laryngeal Nerve Block for Chronic Neurogenic Cough

“…Conduct of chart review was done equal to the previous study. 5 All patients in this study had a complete review of their medical record. Pre- and posttreatment CSI questionnaire scores were recorded for each patient.…”