Mirtazapine 30 mg as a Potential New Therapy for the Treatment of Laryngeal Sensory Neuropathy.

Abstract

Objective: Laryngeal sensory neuropathy (LSN) is an irritating laryngeal disorder that may cause intractable cough, globus sensation, and frequent throat clearing. The diagnosis is typically done by exclusion, even if the postulated etiologies are viral, allergic, or idiopathic. The study aims to introduce mirtazapine 30 mg as a potential new therapy.

Study design: Pilot study.

Subjects and methods: Eighty LSN patients who did not respond to gabapentin and/or amitriptyline were gathered from Minia University Hospital's otorhinolaryngology department and divided into two groups: The Case Group (n = 40) received mirtazapine. In contrast, the Placebo Group (n = 40) administered a placebo capsule once daily for one month. Patients were asked to rank their symptoms on a scale of 0 to 5 in pretreatment and post treatment questionnaires. Voice Handicap Index (VHI) and acoustic analysis were also used as parameters for evaluation. Evidence of treatment intolerance and adverse effects was also documented.

Results: After 1 month of mirtazapine therapy, the mean post treatment chief complaint severity rating was 1.2, while the mean pretreatment one was 3.9. Treatment significantly improved VHI and acoustic scores (P < 0.001) in the case group and differed significantly from the placebo group. Two patients did not tolerate the medications due to dizziness, and four were missed during follow-up.

Conclusion: Mirtazapine 30 seems to be a practical therapy choice for LSN. More research is required to compare the results of this treatment protocol with those of other medications used to treat LSN, including systemic drugs or local interventions such as superior laryngeal nerve block injections, to provide additional context and validation for our findings.