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Superior laryngeal nerve block for neurogenic cough: updated evidence, procedural considerations and practical gaps – a systematic review and clinical perspective

Published online by Cambridge University Press:  13 November 2025

Shayan Shahidi Open the ORCID record for Shayan Shahidi [Opens in a new window] ,
Orla Busby ,
Fatma Sharrif ,
James Holland  and
Nimesh N. Patel
Shayan Shahidi*
Affiliation:
Department of Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Orla Busby
Affiliation:
Department of Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Fatma Sharrif
Affiliation:
Department of ENT, University Hospital Coventry and Warwickshire, Coventry, UK
James Holland
Affiliation:
Department of Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Nimesh N. Patel
Affiliation:
Department of Head and Neck Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
*
Corresponding author: Shayan Shahidi; Email: shayan.shahidi@nhs.net
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Abstract

Objectives

To evaluate the evidence for superior laryngeal nerve block in neurogenic cough and outline practical considerations for clinical use.

Methods

A systematic review was conducted in May 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies reported validated cough-specific quality-of-life outcomes and safety data.

Results

Nine studies (1 randomised trial, 8 case series; n = 490) were included. All studies reported subjective improvement: eight conducted statistical testing and seven showed significant benefit, with the Leicester Cough Questionnaire exceeding the minimal clinically important difference and the Cough Severity Index showing reductions post treatment. Patients received an average of 2 to 3 injections, with follow-up of up to 22 months. Adverse effects were mild and transient. Neuromodulator use and behavioural therapy were inconsistently reported.

Conclusion

Superior laryngeal nerve block appears safe and effective as a short-term intervention, with long-term efficacy remaining uncertain. This review highlights procedural gaps and introduces a structured pathway to guide patient selection, injection and follow up. Robust multicentred trials and consensus guidelines are needed to define long-term benefit and standardise practice.

Keywords

nerve blockneuropathic coughchronic coughlaryngeal nervessystematic review

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 140 , Issue 2 , February 2026 , pp. 137 - 148
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Shayan Shahidi takes responsibility for the integrity of the content of the paper

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