Superior Laryngeal Nerve Block for Cough, Odynophonia, and Irritable Larynx

PROGRAM DESCRIPTION: The superior laryngeal nerve (SLN) block is an office-based procedure that was initially shown to be an effective treatment for chronic neurogenic cough. Chronic cough significantly impacts quality of life, and patients often present to multiple physicians without a clear diagnosis or improvement in their symptoms. As such, it is an extremely frustrating problem for both patients and clinicians. The SLN block is a novel procedural option with a high success rate and has completely changed the treatment algorithm for patients with refractory cough. The indications for SLN block have since been expanded to include other SLN-mediated conditions, such as odynophonia and laryngospasm, that are also typically challenging to treat effectively.

The goal of this course is to familiarize clinicians with the SLN block so that they may offer this treatment to their patients. The SLN block is a safe, low-cost procedure that requires only minutes to complete and can be performed with materials readily available in most otolaryngology clinics. We will discuss the indications for SLN block, procedural details and technique, billing and coding considerations, and expected outcomes of the procedure. We will also explore ways to incorporate the SLN block into a multidisciplinary treatment plan which may include respiratory retraining/voice therapy, medications, and other therapies. This course will give attendees a thorough understanding of the procedure and equip them to select patients for SLN block and counsel them appropriately.

The course directors were the first to describe the SLN block for the above indications, and have published and presented extensively on the topic. Results from published and ongoing studies will be discussed.

OUTCOME OBJECTIVE 1: Identify the indications for in-office superior laryngeal nerve block. Describe the expected outcomes of patients undergoing superior laryngeal nerve block, as well as indications for and timing of re-injection.

OUTCOME OBJECTIVE 2: Demonstrate the injection technique and identify landmarks for the internal branch of the superior laryngeal nerve.

OUTCOME OBJECTIVE 3: Understand how the superior laryngeal nerve block may be incorporated with other treatment modalities for management of chronic cough, odynophonia, and irritable larynx.

BACKGROUND STATEMENT: There is a need for effective treatments for chronic cough and other disorders on the irritable larynx spectrum. Superior laryngeal nerve block is safe, performed in the office setting, and can provide relief to patients with these conditions.

Comprehensive Otolaryngology Track Statement :