- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02286960
Investigation of the Role of Steroids in Enhancing Voice Therapy Outcomes (AAO)
February 27, 2020 updated by: NYU Langone Health
Despite the considerable use of oral steroids in the regular management of benign vocal fold lesions there is little evidence base in the literature.
This study will investigate the efficacy of oral steroids for the treatment of vocal fold lesions in a controlled manner.
The specific aim of this study is to determine the effectiveness of of a short course of oral steroids prior to behavioral voice therapy in patients with benign, phonotraumatic vocal fold lesions.
Enrolled subjects will be randomized using a random numbers table to either receive oral steroids or no steroids prior to the initiation of voice therapy.
The therapist and individuals involved in the collection and analysis of data will be blinded as to whether the subject received drug.
Prior to initiation of therapy subjects will be asked to return for an interval evaluation during which they undergo videostroboscopy and voice evaluation.
Subjects will enter then the voice therapy phase .
After an initial evaluation to determine the best mode of therapy they will receive a behavioral voice therapy course, which includes a range of behavioral modifications and motor learning techniques, along with lifestyle measures.
In all these phases acoustic and aerodynamic measurements will be collected as well as audio-visual material from the videostroboscopic exams.
The investigators hypothesize that oral steroids will lead to a reduction in lesion size, which will substantially aid in the delivery and incorporation of voice therapy techniques, contributing to the improvement of overall laryngeal biomechanics and providing an ideal starting point for behavioral voice therapy.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
The study will investigate the potential added advantage of the use of steroids in patients undergoing voice therapy.
Enrolled subjects will be randomized using a random numbers table to either receive oral steroids or no steroids prior to the initiation of voice therapy.
The therapist and individuals involved in the collection and analysis of data will be blinded as to whether the subject received drug.
Prior to initiation of therapy subjects will be asked to return for an interval evaluation during which they undergo videostroboscopy and voice evaluation.
Subjects will enter then the voice therapy phase .
After an initial evaluation to determine the best mode of therapy they will receive a behavioral voice therapy course, which includes a range of behavioral modifications and motor learning techniques, along with lifestyle measures.
In all these phases acoustic and aerodynamic measurements will be collected as well as audio-visual material from the videostroboscopic exams.
The measurements that will be collected in all these phases are the Voice Handicap Index (VHI)-10 , the noise to harmonic ratio H/N, the fundamental frequency Fo, The transglottic airflow and subglottic pressure.
The investigators hypothesize that oral steroids will lead to a reduction in lesion size, which will substantially aid in the delivery and incorporation of voice therapy techniques, contributing to the improvement of overall laryngeal biomechanics and providing an ideal starting point for behavioral voice therapy.
Study Type
Interventional
Enrollment (Actual)
36
Phase
- Phase 4
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
-
-
New York
-
New York, New York, United States, 10016
- New York University School of Medicine
-
-
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 to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age 18-80 males and females
- Presence of phonotraumatic lesion deemed to be etiologic for the complaint of dysphonia
- Voice therapy deemed to be the primary (or at least initial) treatment to address the dysphonia.
- Willingness to be an active participant in voice therapy.
Exclusion Criteria:
- Use of any glucocorticoids (oral, inhaled, or intravenous) within 3 months of the initial evaluation
- Known allergy or hypersensitivity to oral steroids
- Active infection
- Diabetes Mellitus
- Prior history of radiation to the neck
- Recent myocardial infarction
- Recent gastrointestinal surgery with bowel anastamosis (3 months)
- Active peptic ulcer
- Pregnancy
- Severe depression or history of psycosis
- History of recent laryngeal surgery (within 12 months)
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: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Steroid
Prednizone pills.
4 day course 2 x 20mg per day.
|
A short 4 day course is administered to the first group of patients with voice disorders before the initiation of voice therapy.
Other Names:
|
Placebo Comparator: Placebo
Lactose Pills. 4 day course 2 x 20mg per day.
|
4 day course 2 x 20mg per da
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) Score From Baseline to 2 Months
Time Frame: pre-treatment/baseline to 2 months
|
Data will be collected via measurement of the hatchmark on the 100mm line for each variable (e.g.
72/100).
The higher the score, the higher the deviancy.
The final score is the average of scores from each variable.
|
pre-treatment/baseline to 2 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Lesion Size From Baseline to 2 Months
Time Frame: pre-treatment/baseline to 2 months
|
Still images of the glottis will be obtained from the video such that the vocal folds are captured in an open position (at least 40 degrees at the anterior commissure).
Image J software (NIH) will then be used to outline the lesion and measure the length of the ipsilateral vocal fold.
|
pre-treatment/baseline to 2 months
|
Change in Voice Handicap Index (VHI) Scores From Baseline to 2 Months.
Time Frame: Pre-treatment/baseline to following treatment/2 months
|
A change in VHI scores from pre-treatment to following treatment. Scores can range from 0-120: 0-30: Mild Minimal amount of handicap 31-60: Moderate Often seen in patients with vocal nodules, polyps, or cysts 60-120: Severe Often seen |
Pre-treatment/baseline to following treatment/2 months
|
Number of Participants That Showed Improved (Lower) Average Decibels (db) Output.
Time Frame: 2 months
|
2 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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
July 1, 2013
Primary Completion (Actual)
December 1, 2018
Study Completion (Actual)
December 1, 2018
Study Registration Dates
First Submitted
November 6, 2014
First Submitted That Met QC Criteria
November 7, 2014
First Posted (Estimate)
November 10, 2014
Study Record Updates
Last Update Posted (Actual)
March 12, 2020
Last Update Submitted That Met QC Criteria
February 27, 2020
Last Verified
February 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 13-00096
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
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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