- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04642352
Office-Based Superior Laryngeal Nerve Block for Treatment of Neurogenic Cough
March 25, 2023 updated by: Blake Simpson, University of Alabama at Birmingham
Office-Based Superior Laryngeal Nerve (SLN) Block for Treatment of Neurogenic Cough
The purpose of this study is to evaluate if office-based injection of a local anesthetic/steroid combination at the area of one superior laryngeal nerve can decrease cough frequency and alleviate symptoms of chronic cough in patients with neurogenic cough.
Study Overview
Detailed Description
Neurogenic cough is a chronic cough without a clear cause.
It is thought to be related to irritation of a nerve that goes to the larynx (voice box).
This can happen after a viral upper respiratory infection.
Current treatment uses therapy or medications taken by mouth.
Those medications can be sedating and not well tolerated.
An alternative approach would be to perform an injection "nerve block", which is commonly done for other nerve disorders such as around the spine.
This may help people with neurogenic cough also.
We studied this recently in a small group of patients and found that patients had improvement in their cough symptoms (Simpson 2018).
It would be helpful to study this in a larger group of patients using more methods of evaluating cough symptom severity.
Study Type
Observational
Enrollment (Anticipated)
50
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
-
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Alabama
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Birmingham, Alabama, United States, 35233
- Recruiting
- University of Alabama at Birmingham
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Contact:
- Blake Simpson, MD
- Phone Number: 205-801-7864
- Email: blakesimpson@uabmc.edu
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-
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
Sampling Method
Non-Probability Sample
Study Population
Patients presenting to UAB Department of Otolaryngology for the evaluation and treatment of chronic cough who would be undergoing superior laryngeal nerve block as part of their standard clinical care.
Description
Inclusion Criteria:
- Age 18 years or older
- Ability of patients to speak and understand English
- Ability for patients to consent for themselves
- Cough for 8 weeks or greater, with suspected sensory neuropathic etiology of the cough. Inclusion based on history of preceding upper respiratory infection or other symptoms suggestive of irritable larynx such as cough in response to temperature changes, odors, scents/perfumes, tickle, irritation in the throat/paralaryngeal region, or talking.
Persistent cough despite treatment of ALL the major contributors of cough (items listed below would be done as part of a standard clinical workup for chronic cough and are not done specific to this study):
- Reflux disease treatment with one of the following: failure of two months of PPIs OR negative pH study
- Asthma: lack of response to at least one month of steroid inhaler/bronchodilator OR normal PFTs/negative methacholine challenge + negative CXR/CT
- Upper airway cough syndrome/Allergic disease: lack of response to at least one month of antihistamines/decongestants/nasal steroids OR negative allergy testing (skin or serum) OR lack of response to at least one year of immunotherapy/allergy shots
Exclusion Criteria:
- Age less than 18 years
- Patients unable or unwilling to provide informed consent
- Known etiology to cough other than sensory neuropathy (e.g., reflux disease, asthma, allergic rhinitis, chronic obstructive pulmonary disease)
- Addition of new neuromodulators at the time of the injection. Patients who were already being treated with neuromodulators for their cough (e.g., gabapentin, amitriptyline) will not be excluded provided their dose remains constant.
- Nissen fundoplication within the last year
- Smoking history within last 5 years
- Allergy to bupivacaine or Kenalog-40
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
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
SLN intervention group
Participants will undergo a superior laryngeal nerve (SLN) block
|
A unilateral injection of 2 cc of a 1:1 mixture of 0.25% bupivacaine and Kenalog-40 via a 27 gauge needle to the thyrohyoid space (front of neck, just above larynx/voice box) via a 27 gauge needle to the thyrohyoid space (front of neck, just above larynx/voice box) on the side which exhibited most discomfort/tenderness/cough on palpation.
If neither side was uncomfortable, the right side will be used.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in score on the Leicester Cough Questionnaire
Time Frame: Baseline to 3 months
|
The Leicester Cough Questionnaire consists of 19 questions designed to assess the impact of cough on various aspects of a participant's quality of life.
Scores are chosen from a Likert scale from 1 to 7, with 1 representing "all of the time" and 7 representing "none of the time."
Scores would decrease if symptoms improved.
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Baseline to 3 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this 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 (Actual)
January 3, 2022
Primary Completion (Anticipated)
October 1, 2024
Study Completion (Anticipated)
October 1, 2026
Study Registration Dates
First Submitted
November 19, 2020
First Submitted That Met QC Criteria
November 19, 2020
First Posted (Actual)
November 24, 2020
Study Record Updates
Last Update Posted (Actual)
March 28, 2023
Last Update Submitted That Met QC Criteria
March 25, 2023
Last Verified
March 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Respiration Disorders
- Signs and Symptoms, Respiratory
- Cough
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Sensory System Agents
- Anesthetics
- Anti-Inflammatory Agents
- Immunosuppressive Agents
- Immunologic Factors
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Anesthetics, Local
- Triamcinolone Acetonide
- Bupivacaine
Other Study ID Numbers
- IRB-300005783
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
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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