Summary
Objectives
Topical lidocaine remains the mainstay for anesthesia in transcutaneous vocal fold
injection (VFI). While using topical lidocaine, laryngologists sometimes encounter
uncontrolled reflexes or poor compliance. Superior laryngeal nerve block (SLNB) provides
deep and rapid anesthesia on the larynx above the vocal folds and abolishes the glottic
closure reflex. Herein, we present a pilot study to evaluate the feasibility and safety
of SLNB for transcutaneous VFI and explored its usefulness.
Methods
Fifty-nine patients were prospectively anesthetized with SLNB during transcutaneous
VFI for unilateral vocal fold paralysis. In the SLNB group, 0.5 to 1 mL of 2% lidocaine
was infiltrated on bilateral SLNs through the thyrohyoid membrane. As the control
group, we included previous 47 patients who underwent VFI with topical lidocaine.
In the control group, 10% lidocaine spray was applied to the laryngopharyngeal mucosa.
Demographic data, laryngeal exposure, patient compliance, procedural interruption,
and complications were investigated. Patient compliance was evaluated based on the
frequency of cough and swallowing during VFI procedures.
Results
SLNB enabled endoscopic contact on the epiglottis and pharyngeal wall without gag
reflex and provided good exposure of the procedure field on the vocal folds. In the
SLNB group, the laryngeal exposure is significantly better than in the control (P = 0.005). The frequency of cough and swallowing was significantly lower in the SLNB
group than in the control (P < 0.001). The number of procedural interruptions was lower in the SLNB group than
in the control (P < 0.001). There was no acute or delayed complication related to SLNB such as bleeding,
hematoma, delayed sensory/swallowing problems, or unscheduled hospital visits.
Conclusions
SLNB might be safe and effective for anesthesia in transcutaneous VFI. SLNB could
be a good anesthetic option for patients with poor compliance despite the sufficient
application of topical lidocaine.
Level of Evidence
4
Key Words
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Article info
Publication history
Published online: May 09, 2023
Accepted:
March 16,
2023
Publication stage
In Press Corrected ProofFootnotes
This study was supported by the National Research Foundation of Korea grant funded by the Korea government (Ministry of Science and ICT) (2022R1F1A1074487). The authors have no other funding or financial relationship to disclose.
Identification
Copyright
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
