Treatment of chronic neurogenic cough with in‐office superior laryngeal nerve block

Simpson, C. Blake; Tibbetts, Kathleen M.; Loochtan, Michael J.; Dominguez, Laura M.

doi:10.1002/lary.27201

Cited by 60 publications

(116 citation statements)

References 23 publications

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“…Injection of steroids to treat inflammation of the hyoid was first described in the 1970s . To cover both the neuropathic and inflammatory etiologies, we recommend injection with a local anesthetic/corticosteroid mixture, a strategy that was recently highlighted as a treatment for neurogenic chronic cough and can be repeated as needed …”

Section: Discussionmentioning

confidence: 99%

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Primary odynophonia: When pain is out of proportion to dysphonia

et al. 2019

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Objectives/Hypothesis Odynophonia is generally regarded as a symptom of a voice disorder. However, a subset of patients with odynophonia have debilitating pain out of proportion to the relatively mild degree of dysphonia and are not responsive to voice therapy. The goals of this study were to 1) describe the symptomatology of this subset of patients and differentiate it from typical odynophonia, 2) propose alternate models to explain this phenomenon of primary odynophonia, and 3) present a new treatment paradigm based on the proposed models. Study Design Case series. Methods Inclusion criteria were complaint of persistent pain associated with voicing, normal vocal fold mobility, complete glottic closure, and limited or lack of response of pain to voice therapy. Presenting symptoms, voice evaluation, and treatment outcomes were reviewed. Results Eleven patients fit the inclusion criteria. The degree of pain did not follow the trajectory of vocal improvement with therapy. The pain was stagnant or worsened with voice exercises. The most dramatic improvement came about in one patient who received false vocal fold Botox injections, and another who received thyrohyoid lidocaine/triamcinolone injection. We propose that these patients had developed primary odynophonia, in which the pain had become self‐sustaining and no longer responded to correction of hyperfunctional vocal behavior. The mechanism of pain persistence may involve superior laryngeal neuralgia, cartilaginous or ligamentous inflammation, and/or central sensitization. Conclusions A minority of patients have primary odynophonia distinct from typical odynophonia. Direct treatment of pain may be advisable prior to or in conjunction with voice therapy. Level of Evidence 4 Laryngoscope, 130:E183–E189, 2020

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Section: Discussionmentioning

confidence: 99%

“…Pain can also cause guarding, which leads to laryngeal muscle imbalance that exacerbates dysphonia. recently highlighted as a treatment for neurogenic chronic cough 23 and can be repeated as needed. 16 In some cases, the pain may respond to injections of BoNT-A.…”

Section: Direct Treatment Of Painmentioning

confidence: 99%

Primary odynophonia: When pain is out of proportion to dysphonia

et al. 2019

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“…Superior laryngeal nerve block is an emerging offi ce-based treatment, but it is unknown how many injections are needed for cough suppression. 30 This is a good option for patients who develop diminished responses to neuromodulator therapy or who cannot tolerate adverse effects of this drug class.…”

Section: Superior Laryngeal Nerve Blockmentioning

confidence: 99%

A cough that won’t go away: Evaluation and treatment in 2 patients

Lee

Taliercio

Adessa

et al. 2020

CCJM

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“…La terapia no farmacológica basada en terapia de lenguaje y conductual ha mostrado también benefi cio signifi cativo en la tos crónica. 50 Simpson et al 51 han reportado su experiencia con el bloqueo de la rama interna del nervio la-ríngeo superior en pacientes con tos crónica neurogénica, atribuida a hipersensibilidad laríngea por daño neural aparentemente posviral, logrando disminuir el índice de severidad de la tos en forma signifi cativa, de un promedio pretratamiento de 26.8 a 14.6 postratamiento (p < 0.0001). Esta rama interna penetra la membrana tirohioidea ligeramente por arriba de la arteria laríngea superior; se divide en rama superior e inferior y proporciona sensaciones generales (dolor, tacto, temperatura) por encima de las cuerdas vocales verdaderas.…”

Section: Ensayos Clínicosunclassified

“…Los pacientes describen también una sensación de cuerpo extraño o irritación en la garganta que precede o acompaña a la tos. 51…”

Section: Ensayos Clínicosunclassified

Tos crónica. Síndrome de hipersensibilidad del reflejo de la tos

Sacre-Hazouri¹,

Sacre

2019

RAM

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El reflejo de la tos es un mecanismo de protección de la vía respiratoria, evita la broncoaspiración y sus complicaciones; cuando está alterado puede manifestarse como un síndrome de hipersensibilidad. La tos per se es el síntoma más común por el que se consulta en la práctica médica. La tos crónica representa un problema de salud pública, con alto grado de morbilidad; representa un síndrome por sí mismo, sin importar la condición subyacente. Evidencia reciente sugiere un proceso neurofisiológico anormal y alterado. Se revisó literatura especializada y acerca de los nuevos mecanismos terapéuticos. Estamos en proceso de comprender el síndrome de la tos.

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Treatment of chronic neurogenic cough with in‐office superior laryngeal nerve block

Abstract: 4. Laryngoscope, 1898-1903, 2018.

Cited by 60 publications

References 23 publications

Primary odynophonia: When pain is out of proportion to dysphonia

Primary odynophonia: When pain is out of proportion to dysphonia

A cough that won’t go away: Evaluation and treatment in 2 patients

Tos crónica. Síndrome de hipersensibilidad del reflejo de la tos

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