Disclosures: Eduardo J. Carrera, MD: No financial relationships or conflicts of interest

Case Diagnosis: Globus sensation from neck surgery improved with peripheral nerve stimulation of the recurrent laryngeal nerve.

Case Description: Patient with persistent globus sensation following an anterior cervical discectomy and fusion seven years before presentation. The patient had mild vocal cord weakness, but injection treatment had no effect. She was worked up by gastroenterology without evidence of abnormality. She had a normal sensation, strength, and reflex exam in all extremities. Globus sensation was unresponsive to cervical medial branch blocks, stellate ganglion block, vagus nerve block, glossopharyngeal nerve stimulation, or superior laryngeal nerve blocks. A decision was made to pursue peripheral nerve stimulation of laryngeal nerves.

Setting: Outpatient pain clinic.Assessment/

Results: The patient underwent peripheral nerve stimulator placement to the superior laryngeal nerve without significant improvement in symptoms. Peripheral nerve stimulation to the inferior laryngeal nerve improved globus symptoms by 90% during the two-month device placement period. The patient denied changes in voice or swallowing following device placement and reported a drastic improvement in her quality of life thanks to this procedure.

Discussion: This is the first reported case of peripheral nerve stimulation to the recurrent laryngeal nerve to treat globus. This poster describes this novel procedure in detail. The standard of care for globus sensation is not well-defined, particularly for those who fail initial therapy. Years of uncontrolled globus symptoms in this patient prompted a more extensive work-up and therapeutic trials without relief before the recurrent laryngeal nerve intervention. While the use of laryngeal pacemakers on the recurrent laryngeal nerve has been suggested for recurrent laryngeal nerve paralysis, peripheral nerve stimulation targeting the recurrent laryngeal nerve has never been previously documented for the treatment of globus.

Conclusion: This novel approach using peripheral nerve stimulation to target the recurrent laryngeal nerve offers a minimally invasive approach to relieve refractory globus sensation.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/novel-use-of-peripheral-nerve-stimulation-to-the-recurrent-laryngeal-nerve-for-treatment-of-globus-following-cervical-surgery-a-case-report/