Paroxysmal laryngospasm after laryngeal nerve injury

Objective: Describe a clinical syndrome of laryngeal hypersensitivity follo wing laryngeal nerve injury. Study Design: Retrospective review of six pati ents with laryngeal paralysis sustained during neck surgery who presented w ith paroxysms of coughing and strider, progressing to brief episodes of com plete airway occlusion, Methods: Chart review. Results: Superior laryngeal nerve blockade temporarily improved symptoms in four of five patients. Botu linum toxin relieved spasm in two of three patients and reduced symptoms in the third. Symptoms gradually diminished or resolved in four patients from 1 to 2.5 years later. One patient underwent arytenoidectomy and one patien t has a tracheostomy, Conclusions: patients with laryngeal injury may prese nt with strider and acute airway obstruction secondary to paroxysmal laryng ospasm. The authors have found that superior laryngeal nerve blockade or bo tulinum toxin may be effective in temporary relief of symptoms.