The Effect of Inhaled Corticosteroids on Vocal Fold Nodules in Children

  • STATUS
    Recruiting
  • End date
    Jun 24, 2024
  • participants needed
    12
  • sponsor
    Joseph Dohar, MD
Updated on 24 July 2022

Summary

Voice disorders are the most common communication disorder across the lifespan and vocal fold nodules are the most frequent pathology affecting voice in children. The goal of the present study is to determine the safety and feasibility of a short-course of inhaled corticosteroids in addition to standard voice therapy for treating vocal fold nodules.

Description

Voice disorders are the most common communication disorder across the lifespan, affecting more than 5 million school-aged children annually in the United States. Vocal fold nodules are the most frequent pathology affecting voice in children, with 21% of children negatively influenced at any given point in time, resulting in negative quality of life consequences and inferior academic performance. The traditional first-line approach to treatment of vocal fold nodules is voice therapy by Speech-Language Pathology, although corticosteroids are often implemented in conjunction with voice therapy to reduce focal inflammation at the lesion site. Operating room procedures are the traditional method to administer corticosteroids to the lesion site, although recent advances in office-based laryngeal steroid injections have become a widely popular alternative to reduce lesion size. Unfortunately, although in-office injections are more favorable to operating room procedures, due to their less invasive nature, in-office procedures are still an invasive alternative in the pediatric population. Specifically, they involve equipment that may be intimidating to the child and require the child to remain very still for prolonged periods of time, which may not be feasible with some children. Furthermore, focal vocal fold injections still involve potential adverse effects such as vocal fold hematoma. To mediate these concerns, a short course of inhaled corticosteroids may be a safe and non-invasive alternative to reducing inflammation and lesion size within the larynx. The goal of the present study is to determine the safety and feasibility of a short-course of inhaled corticosteroids in addition to standard voice therapy for treating vocal fold nodules. The study also aims to examine the effects of inhaled corticosteroids on quality of life outcomes and acoustic and aerodynamic outcomes.

Details
Condition Vocal Fold Nodules
Treatment Fluticasone propionate, Standard voice therapy
Clinical Study IdentifierNCT03040596
SponsorJoseph Dohar, MD
Last Modified on24 July 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Newly diagnosed with vocal fold nodules
Considered behaviorally and cognitively appropriate by PI for voice therapy
English comprehension and production sufficient to participate in the protocol and in voice therapy
Not currently on inhaled corticosteroids
No previous voice therapy
Willing to participate in voice therapy at Children's Hospital of Pittsburgh

Exclusion Criteria

Other medical conditions or medications that would mask or amplify voice outcomes, including developmental or other neuromuscular conditions, major illness or disorders, chronic or acute with the exception of laryngopharyngeal reflux disease or allergies and their treatments
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