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The superior laryngeal nerve is blocked at the lower border of the hyoid bone.
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A small 25-gauge, short needle is used to reduce the risk of intravascular or intralaryngeal injections.
Perspective
The superior laryngeal nerve block is one of the methods of providing airway anesthesia. Block of the superior laryngeal nerve provides anesthesia of the larynx from the epiglottis to the level of the vocal cords.
Patient Selection. This block may be appropriate for any patient requiring tracheal intubation before anesthetic induction.
Pharmacologic Choice. Lidocaine (0.5%) is an appropriate local anesthetic for this block.
Placement
Anatomy. The superior laryngeal nerve is a branch of the vagus nerve. After it leaves the main vagal trunk, it courses through the neck and passes medially, caudal to the greater cornu of the hyoid bone, at which point it divides into an internal branch and an external branch. The internal branch is the nerve of interest in superior laryngeal nerve block, and it is blocked where it enters the thyrohyoid membrane just inferior to the caudal aspect of the hyoid bone ( Fig. 27.1 ).
