- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02163772
Early Intracordal Hyaluronic Acid Injection During Spontaneous Reinnervation for Unilateral Recurrent Laryngeal Nerve Paralysis
June 12, 2014 updated by: Chang Gung Memorial Hospital
Backgrounds: Unilateral vocal cord paralysis caused from recurrent laryngeal nerve (RLN) injury is not an unusual disease and may deteriorate patients'voice and swallowing outcomes.
Although the long term treatment effect is encouraged, the point when to perform surgical treatment is not conclusive.
Previous reports suggested late treatment principle because patients may spontaneous reinnervation to some degree within 4-5 months after injury.
The vocal cord position and tone may change during reinnervation.
Others delineated laryngeal synkinesis by misdirected reinnervation is common and suggested early temporary injection laryngoplasty.
They implied early injection laryngoplasty may improve patients'not only short term voice outcomes but also decrease the incidence of transcervical laryngeal framework surgery as a determined surgery.
However, lacking of prospective study and objective data makes the treatment-time policy still controversial.
Purposes: 1.
To find incidence of spontaneous reinnervation or synkinetic regeneration.
2. To detect the relationship between changing of glottal gap and laryngeal synkinesis.
3. To detect the impaction of early intracordal hyaluronic acid injection on vocal cord position change in patients with laryngeal synkinesis.
Study design: Forty patients is planned to be enrolled in the study.
Twenty of them will undergo hyaluronate intracordal injection at three-six month from RLN damage.
The other 20 patients will follow the watch-and wait policy.
Laryngoscope, laryngeal EMG (electromyography), voice analysis and voice outcome survey will be done at 3-6 month and 12-month after RLN injury.
At the end of follow up, the glottal gap, voice laboratory data and quality of life will be compared.
The outcomes will also be correlated with laryngeal electromyography (LEMG) data and the impact of synkinetic reinnervation.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
29
Phase
- Not Applicable
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
-
-
-
Taoyuan County, Taiwan
- Chang Gung Memorial Hospital
-
-
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:
- Patients of untreated unilateral vocal cord paralysis with a known cause of RLN injury within 3-6 month will be enrolled
Exclusion Criteria:
- Patients proved to be not suitable for transcutaneous intracordal injection under topical anesthesia. Those who had previous phonosurgery or can't follow the observation rule will also be excluded.
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
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intracordal hyaluronate injection (HI)
The intervention of Intracordal hyaluronate (Restylane) injection is given in this group No other therapies are given
|
Other Names:
|
No Intervention: Conservative management (CM)
In this arm, only observation is arranged.
No therapy is given.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
voice outcome
Time Frame: before intervention and at 6 month follow-up
|
VOS score: The VOS originally developed by Gliklich et al. comprises a five-item survey that evaluates the physical and social problems associated with unilateral vocal fold palsy.
|
before intervention and at 6 month follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
laryngeal electromyography
Time Frame: before and 6 months post intervention
|
laryngeal electromyography signals were obtained using a concentric needle electrode with the surface-ground electrode adhered to the forehead.
We examined the electromyography signals on bilateral thyroarytenoid muscle and cricothyroid muscles.
With the concentric needle electrode in the thyroarytenoid muscle , the patient was asked to produce three series of "e"s at three different intensities (low, moderate and highest possible), with each "e" lasting at least 400 ms and each inter-"e" interval lasting about 200 ms.
To evaluate cricothyroid function, the patients were asked to produce a glissando upward "e" at normal loudness.
|
before and 6 months post intervention
|
videolaryngostroboscopy
Time Frame: before and 6 months post intervention
|
An image of glottis was captured during the videolaryngoscopy examination while the patient vocalized /eee/ at modal pitch and regular loudness.
The images showing the narrowest vocal slitglottal gap from several phonatory cycles were measured.
|
before and 6 months post intervention
|
laboratory voice analysis
Time Frame: before and 6 months post intervention
|
In a sound-insulated room, the patient read a standard passage and a sustained vowel at a conversational pitch and loudness.
The patient's voice was captured using a unidirectional dynamic microphone (Shure SM48; Shure Brothers Inc., Agua Prieta, Mexico).
|
before and 6 months post intervention
|
health related quality of life (SF-36)
Time Frame: before and 6 months post intervention
|
The SF-36 questionnaire is designed for general health measurement of 8 domains, including physical functioning, role functioning-physical problems, bodily pain, general health, vitality, social functioning, role functioning-emotional problems, and mental health.
The recall period of SF-36 is 4 weeks.
|
before and 6 months post intervention
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
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
August 1, 2011
Primary Completion (Actual)
July 1, 2013
Study Registration Dates
First Submitted
June 10, 2014
First Submitted That Met QC Criteria
June 12, 2014
First Posted (Estimate)
June 16, 2014
Study Record Updates
Last Update Posted (Estimate)
June 16, 2014
Last Update Submitted That Met QC Criteria
June 12, 2014
Last Verified
July 1, 2013
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- NSC100-2314-B-182-021
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.
Clinical Trials on Paralysis, Unilateral, Vocal Cord
-
University of FloridaCompletedUnilateral Vocal Cord Paralysis | Unilateral Vocal Cord ParesisUnited States
-
Lawson Health Research InstituteUnknownUnilateral Vocal Cord LesionsCanada
-
Cliniques universitaires Saint-Luc- Université...Active, not recruitingUnilateral Vocal Cord ParalysisBelgium
-
Royal National Throat, Nose and Ear HospitalUniversity College London Hospitals; University College Joint Research Office; NIHR Research for Patient Benefit (RfPB) and other collaboratorsCompletedVocal Cord Paralysis UnilateralUnited Kingdom
-
National Institute on Deafness and Other Communication...Terminated
-
APrevent Biotech GmbHCompletedParalysis, Unilateral, Vocal CordAustria
-
Chang Gung Memorial HospitalUnknownUnilateral Vocal Cord ParalysisTaiwan
-
Chang Gung Memorial HospitalUnknownUnilateral Vocal Cord ParalysisTaiwan
-
APrevent Biotech GmbHRecruitingParalysis, Unilateral, Vocal CordAustria, United States, Germany
-
Hospital General Universitario Gregorio MarañonCompletedVocal Cord Paralysis, UnilateralSpain
Clinical Trials on Intracordal hyaluronate injection
-
Henry DeGroot, M.D.CompletedOsteoarthritisUnited States
-
DiscGenics, Inc.CTI Clinical Trial and Consulting ServicesCompletedDegenerative Disc DiseaseUnited States
-
Peking University People's HospitalUnknown
-
Seoul National University HospitalCompletedAdhesive CapsulitisKorea, Republic of
-
Actavis Inc.CompletedOsteoarthritisUnited States
-
University of Western Ontario, CanadaUnknownOsteoarthritis, KneeCanada
-
OhioHealthCompletedKnee OsteoarthritisUnited States
-
Cellular Biomedicine Group Ltd.Not yet recruitingKnee OsteoarthritisChina
-
Xijing HospitalRecruitingCartilage Injury | Osteoarthritis Knees Both | Meniscus Disorder | Platelets-rich PlasmaChina
-
Shaare Zedek Medical CenterCompleted