Surgery for Vocal Cord Paralysis

April 21, 2006 updated by: National Institute on Deafness and Other Communication Disorders (NIDCD)

Medialization Vs Reinnervation for Vocal Cord Paralysis

Unilateral vocal fold paralysis (UVFP) is caused by injury to the nerve to the affected vocal fold. The injury to the vocal fold makes the affected person's voice sound "breathy". Voice therapy is usually tried first, and, if unsuccessful, surgical treatment is considered. The standard surgical treatment is called vocal fold medialization and aims to bring the injured cord to the midline. An alternative surgical treatment, vocal fold reinnervation, aims to bring a new nerve supply to the injured vocal fold. The reinnervation operation, which has some potential advantages over the medialization operation also requires several months for final results to be gained. The goal of this multicenter, randomized clinical trial is to see which of the two surgical treatments produces a better outcome.

In order to participate in this study patients with UVFP must meet all entry criteria and must be released from voice therapy by a speech-language pathologist. Information collected for the study (pre-surgery, and at 6 and 12 months after surgery) includes voice recordings, movies made of vocal fold function, airflow and pressure measurements of the voicebox, and an outcomes questionnaire.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

Unilateral vocal fold paralysis (UVFP) is caused by injury to the recurrent laryngeal nerve. Patients with UVFP may have significant impairment of vocal fold function, including a breathy paralytic dysphonia. There are several available approaches for the treatment of this condition. Vocal fold medialization is currently used by most otolaryngologists and is probably the standard of care for treating UVFP. An alternative approach is laryngeal reinnervation, which has a number of potential advantages over medialization but which requires several months before a final result is achieved. The primary goal of this multicenter, randomized clinical trial is to determine which approach produces a better outcome.

Patients with UVFP meeting all inclusion criteria and released from therapy by a speech-language pathologist will be randomized into either the medialization arm or the reinnervation arm. The data collection protocol consists of voice recordings, aerodynamic measurements, electroglottography, videostroboscopy, and a clinical outcomes questionnaire collected pre-treatment and at 6 and 12 months post-treatment.

Study Type

Interventional

Enrollment

300

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Alabama
      • Birmingham, Alabama, United States
        • University of Alabama-Birmingham
    • California
      • Irvine, California, United States
        • UC-Irvine Medical Center
    • District of Columbia
      • Washington, District of Columbia, United States
        • George Washington University
    • Minnesota
      • Minneapolis, Minnesota, United States
        • University of Minnesota
    • Missouri
      • St. Louis, Missouri, United States, 63110
        • Washington University
    • Ohio
      • Cincinnati, Ohio, United States
        • University of Cincinnati
      • Cleveland, Ohio, United States
        • Cleveland Clinic
    • Oklahoma
      • Oklahoma City, Oklahoma, United States
        • University of Oklahoma
    • Pennsylvania
      • Philadelphia, Pennsylvania, United States
        • Thomas Jefferson University
    • Utah
      • Salt Lake City, Utah, United States
        • University of Utah
    • Wisconsin
      • Madison, Wisconsin, United States
        • University of Wisconsin
      • Milwaukee, Wisconsin, United States
        • Medical College Of Wisconsin

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion criteria

  • clinical diagnosis of unilateral vocal fold paralysis
  • older than 18 years of age
  • intact ansa cervicalis and recurrent laryngeal nerves
  • life expectancy of greater than 2 years
  • onset of the vocal fold paralysis within 2 years of the time of surgery
  • no gelfoam injection for at least 4 months prior to initial data collection
  • able to give informed consent
  • willing and able to return for 6 and 12 month data collection sessions
  • able and willing to perform questionnaire (by mail) 18 months after surgery

Exclusion criteria

  • abnormal non-paralyzed fold
  • other disorders affecting the larynx (voice box), such as multiple sclerosis, myasthenia gravis, spasmodic dysphonia, or essential voice tremor
  • prior surgery to either vocal fold
  • previous or planned irradiation of the voicebox

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Institute on Deafness and Other Communication Disorders (NIDCD)

Investigators

  • Principal Investigator: Randal C Paniello, MD, Washington University School of Medicine

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2002

Primary Completion

December 7, 2022

Study Completion

October 1, 2005

Study Registration Dates

First Submitted

July 9, 2003

First Submitted That Met QC Criteria

July 9, 2003

First Posted (Estimate)

July 10, 2003

Study Record Updates

Last Update Posted (Estimate)

April 24, 2006

Last Update Submitted That Met QC Criteria

April 21, 2006

Last Verified

April 1, 2006

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • U01DC004681 (U.S. NIH Grant/Contract)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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