The Role of Bilateral Superior Laryngeal Nerve Block in Managing Refractory Chronic Cough
Brooke A. Quinton, William S. Tierney, Michael S. Benninger, Rebecca C. Nelson, Victoria L. Gau, Candace Hrelec, Paul C. Bryson
Abstract
OBJECTIVE(S): The aim was to investigate the utilization and efficacy of bilateral superior laryngeal nerve block in patients with refractory chronic cough. METHODS: A retrospective chart review of 164 patients with refractory chronic cough who underwent bilateral SLN block at a single institution between November 2018 and September 2022 was performed. Demographics, comorbidities, and patient-reported outcomes including pre- and postinjection Leicester Cough Questionnaire (LCQ) scores were collected and analyzed. RESULTS: The cohort underwent an average of 2.97 bilateral injections (range 1-22), containing either corticosteroid and local anesthetic or corticosteroid alone. Notably, 116 of 164 of patients reported an average of 67.3% reduction in their symptoms, with the treatment effect lasting 7.60 weeks on average. The average pre- and postinjection LCQ scores were 9.70 and 13.82, respectively. A lower LCQ score represents a greater impairment of health status due to cough, and the minimum important change is 1.3 points between questionnaires. The average improvement on LCQ following bilateral SLN block was 4.11 points for this cohort. CONCLUSION: The use of in-office bilateral SLN block is an effective treatment that can be used alone or in conjunction with oral medications for the treatment of refractory chronic cough. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:1773-1777, 2024.