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We all know someone who’s always coughing — at the dinner table, in meetings, during movies — and they never seem to know why. If that someone is you, after the common and serious medical conditions are ruled out, the answer may lie in an unexpected place: your nerves.

Many individuals suffer from chronic, unexplained coughing — persistent symptoms that continue well beyond the typical recovery period for respiratory infections or allergic flare-ups. When standard treatments fail and symptoms like dry coughing or constant throat clearing persist, the cause may be nerve hypersensitivity, not a lung or sinus issue. Fortunately, there is a solution that may work that does not involve endless lozenges or trial-and-error medications.

At the ENT Specialty Group, we have specialists who offer a treatment known as the Superior Laryngeal Nerve (SLN) block injection, designed to target and “calm” an overactive sensory nerve that may be responsible for your symptoms.

Understanding Neurogenic Cough

A neurogenic cough, also called laryngeal hypersensitivity, occurs when the superior laryngeal nerve becomes overly sensitive and starts firing signals to cough—even when there is no meaningful irritation. This condition can result in a constant cough or frequent throat clearing that does not respond to standard medications or treatments.

Neurogenic cough is classified as chronic when symptoms persist for more than eight weeks without a clear underlying cause such as smoking, infection, or structural lung disease.

Essential Differential Diagnosis: What Must Be Ruled Out First

Before treating neurogenic cough, it is essential for your health care provider to rule out common and serious causes. Some of these include:

• Gastrointestinal causes, such as acid reflux (GERD)
• Sinus-related conditions, including chronic rhinosinusitis or allergic rhinitis
• Pulmonary conditions, such as asthma, bronchitis, or neoplasms
• Vocal cord / Throat conditions, nodules, polyps, cysts, tumors…etc
• Autoimmune conditions

Once these possibilities have been investigated and addressed as needed, neurogenic cough may be considered.

What is SLN Injection?

The SLN injection is a targeted nerve block procedure that delivers a small amount of local anesthetic combined with a corticosteroid to the superior laryngeal nerve, typically on one or both sides of the neck.

This helps reduce hypersensitivity by temporarily interrupting abnormal nerve signaling, providing the nervous system time to reset. In most cases, a steroid is used routinely to extend the therapeutic effect.

In addition to treating neurogenic cough, SLN blocks are also used in patients with chronic throat clearing, a symptom that often shares the same underlying mechanism.

What to Expect During the Procedure

• No sedation is required; the patient remains fully awake and alert
• The nerve is located through manual palpation, using anatomical landmarks
• A fine needle is used to administer the injection near the superior laryngeal nerve
• The full procedure typically takes 10 to 15 minutes

The injection is performed in-office, and patients are typically able to return to normal activities shortly afterward.

Post-Procedure Expectations and Results

• Patients may notice temporary throat numbness or a slight change in voice tone for a few hours
• Many experience significant reduction in cough within days
• Some patients may require a second injection for full symptom resolution
• In appropriate cases, the SLN block may be combined with speech-language therapy for enhanced long-term results

Schedule a Consultation

If you or your patient is struggling with a persistent cough that has not responded to standard treatment, contact ENT Specialty Group to learn whether an SLN injection may be an appropriate next step.