Nerve Block Eases Neurogenic Cough in Meta-AnalysisLaryngeal nerve block shows promise for treating neurogenic cough
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck SurgeryPublished September 6, 2026Study authors: Cabral Thamiris D D, Knoll Renata M, Vendramini Bruno D V, Plane Jaime, Conrado João Evangelista P, …PubMed ↗DOI ↗Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain
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Key Takeaway
Superior laryngeal nerve block improves neurogenic cough in 74% of patients with a favorable safety profile.
Neurogenic cough, a chronic condition arising from neural dysfunction, often resists standard treatments. A new meta-analysis suggests that superior laryngeal nerve block (SLNB) may offer significant relief. The analysis pooled data from 552 patients across multiple studies, focusing on subjective improvement and patient-reported outcomes.
Results showed that 74.04% of patients reported subjective improvement in cough (95% CI 68.61-78.81, I²=13.6%). Additionally, Cough Severity Index scores decreased significantly, with a mean difference of -7.37 (95% CI -13.42 to -1.32, P=.02). Notably, patients receiving three or more injections experienced even greater score reductions (MD -10.57, 95% CI -19.37 to -1.78).
Safety data indicated that local transient adverse events occurred in 17.91% of patients, while systemic transient events were less common (3.35%). Serious or injection-limiting adverse events were rare, at 1.97%. The authors describe the safety profile as favorable, supporting SLNB as a viable option for this challenging condition.
However, the authors caution that the evidence level is II, with high heterogeneity for Cough Severity Index outcomes (I²=81.7%). They emphasize the need for large-scale clinical trials to confirm efficacy and assess long-term effects. The meta-analysis primarily included retrospective studies, so causality cannot be firmly established.
For clinicians, SLNB may benefit a substantial subset of patients with neurogenic cough who have not responded to conventional therapies. Given the favorable safety profile, it could be considered as a therapeutic option, though shared decision-making should address the uncertainty regarding long-term outcomes.
Living with a persistent, uncontrollable cough can be exhausting and frustrating. For people with a neurogenic cough, a specific procedure called a superior laryngeal nerve block (SLNB) may offer relief. This procedure targets the nerves in the throat to calm the cough reflex.
Data from 552 patients shows that about 74% of people reported their cough improved after the procedure. The study also found that scores on the Cough Severity Index dropped significantly. Interestingly, patients who received three or more injections saw even greater reductions in their cough severity scores.
Safety is a major factor for patients. The procedure had a favorable safety profile, with only a small number of patients experiencing serious issues. While the results are encouraging, the evidence comes from a collection of older studies. Larger clinical trials are still needed to confirm how well this works over the long term.
What this means for you:
A laryngeal nerve block can significantly reduce cough severity for many patients with a favorable safety profile.
Common questions
How effective is a laryngeal nerve block for a neurogenic cough?
About 74.04% of patients reported an improvement in their cough after the procedure. The study also showed a significant decrease in Cough Severity Index scores, with even greater reductions seen in patients who received three or more injections.
Is the laryngeal nerve block procedure safe?
The procedure has a favorable safety profile. While 17.91% of patients had local transient issues and 3.35% had systemic transient issues, only 1.97% experienced serious events that limited the injection.
Are the results of this treatment confirmed for the long term?
The current evidence is based on a collection of studies and is not yet confirmed by large-scale clinical trials. More research is needed to understand the long-term effects and confirm the treatment's effectiveness over time.
OBJECTIVE: We aimed to assess cough symptom improvement following superior laryngeal nerve block (SLNB) in patients with neurogenic cough (NC).
DATA SOURCES: Studies were systematically searched on PubMed, Embase, Web of Science, and Cochrane Library.
REVIEW METHODS: Articles reporting SLNB for the treatment of NC were included. Outcomes of interest included subjective reporting of improvement, patient-reported outcome measures, and adverse events. Mean difference (MD) was used for continuous outcomes and proportions for binary endpoints, with 95% confidence intervals (CI).
RESULTS: Eight retrospective studies involving 552 patients met inclusion criteria. The pooled proportion of subjective improvement of cough following SLNB was 74.04% (95% CI 68.61-78.81, I² = 13.6%). Patients experienced a statistically significant reduction in Cough Severity Index scores (MD -7.37, 95% CI -13.42 to -1.32, P = .02, I² = 81.7%), with the greatest reduction in those who underwent 3 or more injections (MD -10.57, 95% CI -19.37 to -1.78, I² = 33.4%, P = .02). Adverse events were minimal and self-resolving, with 17.91% and 3.35% of patients experiencing local transient and systemic transient events, respectively. Injection-limiting/serious adverse events were rare, occurring in 1.97% of patients.
CONCLUSION: Our findings suggest that SLNB may benefit a substantial number of patients, as evidenced by improvements in both subjective reports and cough-specific patient-reported outcomes, while maintaining a favorable safety profile with minimal adverse events. Additionally, patients who received multiple injections generally experienced greater reductions in cough severity. Further large-scale clinical trials are needed to confirm the efficacy and long-term effects of this treatment modality.
LEVEL OF EVIDENCE: II.
