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Surgery for Vocal Cord Paralysis

This study has been terminated.
Information provided by:
National Institute on Deafness and Other Communication Disorders (NIDCD) Identifier:
First received: July 9, 2003
Last updated: April 21, 2006
Last verified: April 2006

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.

Condition Intervention Phase
Unilateral Vocal Cord Paralysis Procedure: vocal fold medialization Procedure: vocal fold reinnervation Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
Official Title: Medialization Vs Reinnervation for Vocal Cord Paralysis

Resource links provided by NLM:

Further study details as provided by National Institute on Deafness and Other Communication Disorders (NIDCD):

Estimated Enrollment: 300
Study Start Date: October 2002
Estimated Study Completion Date: October 2005
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.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00064571

United States, Alabama
University of Alabama-Birmingham
Birmingham, Alabama, United States
United States, California
UC-Irvine Medical Center
Irvine, California, United States
United States, District of Columbia
George Washington University
Washington, District of Columbia, United States
United States, Minnesota
University of Minnesota
Minneapolis, Minnesota, United States
United States, Missouri
Washington University
St. Louis, Missouri, United States, 63110
United States, Ohio
University of Cincinnati
Cincinnati, Ohio, United States
Cleveland Clinic
Cleveland, Ohio, United States
United States, Oklahoma
University of Oklahoma
Oklahoma City, Oklahoma, United States
United States, Pennsylvania
Thomas Jefferson University
Philadelphia, Pennsylvania, United States
United States, Utah
University of Utah
Salt Lake City, Utah, United States
United States, Wisconsin
University of Wisconsin
Madison, Wisconsin, United States
Medical College of Wisconsin
Milwaukee, Wisconsin, United States
Sponsors and Collaborators
National Institute on Deafness and Other Communication Disorders (NIDCD)
Principal Investigator: Randal C Paniello, MD Washington University School of Medicine
  More Information Identifier: NCT00064571     History of Changes
Other Study ID Numbers: U01DC004681 ( U.S. NIH Grant/Contract )
Study First Received: July 9, 2003
Last Updated: April 21, 2006

Keywords provided by National Institute on Deafness and Other Communication Disorders (NIDCD):
unilateral vocal fold paralysis

Additional relevant MeSH terms:
Vocal Cord Paralysis
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Laryngeal Diseases
Respiratory Tract Diseases
Otorhinolaryngologic Diseases
Vagus Nerve Diseases
Cranial Nerve Diseases processed this record on August 18, 2017