Survey of Practice Patterns in the Use of Superior Laryngeal Nerve Blocks.

Abstract

Objective: Superior laryngeal nerve (SLN) injection is performed for a variety of upper aerodigestive tract-related indications. Existing literature examines the efficacy of SLN injection for specific indications. However, there is a paucity of insight into overall practice patterns and a lack of standardization, particularly with regards to medication and dosing, treatment time frame, and circumstances. The goal of this study is to elucidate the practice patterns of SLN injection and allow for broader understanding of its utilization.

Data sources/methods: This is a descriptive study of results from an electronic survey disseminated via email to US-based and international otolaryngologists and laryngologists.

Results: 80 responses were collected. 53.8% responders endorsed utilizing SLN injection in their practice, including 39/43 laryngologists (90.7%). Responders perform SLN injection for an array of indications, using a variety of anesthetic and steroid combinations and dosages. The most used steroid is triamcinolone (81.4%). The most used anesthetic is lidocaine (53.5%). 43% of respondents endorse willingness to perform bilateral injections simultaneously. Follow-up after initial injection is highly inconsistent, as are time intervals between injections and number of injections performed. With regards to side effects and complications discussed prior to the procedure, 95% counseled patients on pain/discomfort while roughly half of responders discussed bleeding/hematoma, aspiration risk, vasovagal response, and/or globus sensation, respectively.

Conclusions: This is the first known study investigating the practice patterns of SLN injection. The substantial variability of responses reflects a lack of standardization of this procedure despite its widespread use. Further study is needed to optimize protocols.

Level of evidence: Levels 5 and 6 Laryngoscope, 2024.