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Investigators will assess the usefulness of using ultrasound in office procedures for laryngology interventions. Participants who qualify will be adults who are undergoing superior laryngeal nerve block, injection laryngoplasty, swallowing evaluation, voice evaluation and voice therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cough | Experimental | Adult patients who are seen at the Sean Parker Institute for the Voice and are determined to have neurogenic cough for which superior laryngeal nerve block is recommended will undergo this procedure under ultrasound guidance. Patients without neurogenic cough will also be recruited for ultrasound assessment to establish landmarks and normal variation. |
|
| Vocal Cord Atrophy | Experimental | Adult patients with vocal fold atrophy, paresis, or paralysis diagnosed at the Sean Parker Institute for the Voice who are planned to undergo injection laryngoplasty will be invited to take part in the study. |
|
| Vocal Cord Paresis | Experimental | Adult patients with vocal fold atrophy, paresis, or paralysis diagnosed at the Sean Parker Institute for the Voice who are planned to undergo injection laryngoplasty will be invited to take part in the study. |
|
| Vocal Cord Paralysis | Experimental | Adult patients with vocal fold atrophy, paresis, or paralysis diagnosed at the Sean Parker Institute for the Voice who are planned to undergo injection laryngoplasty will be invited to take part in the study. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrasound for cough | Diagnostic Test | Adult patients who are seen at the Sean Parker Institute for the Voice and are determined to have neurogenic cough for which superior laryngeal nerve block is recommended will undergo this procedure under ultrasound guidance. Patients without neurogenic cough will also be recruited for ultrasound assessment to establish landmarks and normal variation. Patients will be assessed for their comfort with undergoing the procedure and clinicians will be surveyed on the ease and benefit of performing the procedure under ultrasound guidance. |
| Measure | Description | Time Frame |
|---|---|---|
| Quantitative clinician-reported usability measure of ultrasound during injection of the internal branch of superior laryngeal nerve for neurogenic cough. | The clinician will use the Likert scale and rate a series of statements on a scale of 1 (strongly disagree) to 5 (strongly agree). The lowest possible total score is 12 (overall clinician disagreement), and the highest possible total score is 60 (overall clinician agreement). | Immediately post-intervention |
| Qualitative clinician-reported usability measure of ultrasound during injection of the internal branch of superior laryngeal nerve for neurogenic cough. | The clinician will respond to the following open-ended questions:
| Immediately post-intervention |
| Patient comfort measures during ultrasound-guided injection of the internal branch of superior laryngeal nerve for neurogenic cough. | Number of patients that fall into the below categories as determined by the provider care team:
| Day 1 |
| Time to complete superior laryngeal nerve injection under ultrasound. | The amount of time will be recorded in minutes. | Day 1 |
| Images and descriptors of internal branch of superior laryngeal nerve anatomy and normal variation. | This is a qualitative outcome measure. Providers will provide a description of the internal branch of superior laryngeal nerve anatomy with accompanying images from the strobe. |
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Inclusion Criteria:
US-Guided Injection for Neurogenic Cough:
US-Assessment of Superior Laryngeal Nerve Anatomy
US-Assessment of Injectate Volume:
US-Assessment of Swallow:
US-Assessment of Normal Swallow:
US-Assessment of Voice:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| John Ramos, BA | Contact | (646) 962-7464 | 19882 | jmr4003@med.cornell.edu |
| Joclin Rabinovich, BS | Contact | (646) 962-7464 | 19882 | jor4039@med.cornell.edu |
| Name | Affiliation | Role |
|---|---|---|
| Anaïs Rameau, MD | Weill Medical College of Cornell University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Weill Cornell Medicine | New York | New York | 10021 | United States |
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| Dysphagia | Experimental | Adult patients referred to the Sean Parker Institute for the Voice for swallowing assessment will undergo standard medical history including collection of age, gender, occupation, characteristics of swallowing complaints, and prior evaluation and treatments. Adult patients without swallowing complaints will also be recruited to define normal anatomy and variation. |
|
| Dysphonia | Experimental | Adult patients referred to the Sean Parker Institute for the Voice for voice assessment will undergo standard medical history including collection of age, gender, occupation, characteristics of voice complaints, and prior evaluation and treatments. Additionally, patients diagnosed with muscle tension dysphonia will be evaluated by ultrasound for the presence, size, and function of their suprahyoid musculature. |
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| Ultrasound for vocal fold atrophy or vocal fold paresis/paralysis | Diagnostic Test | Adult patients who are seen at the Sean Parker Institute for the Voice and are determined to have vocal fold atrophy or vocal fold paresis/paralysis for whom injection laryngoplasty is recommended will undergo laryngeal ultrasound prior to the procedure to assess baseline anatomy as well as following the procedure (both immediately following the procedure as well as at follow-up visits) in order to assess the amount of injectate. |
|
| Ultrasound for dysphagia | Diagnostic Test | Patients with and without swallowing complaints will be enrolled to assess their tongue, suprahyoid and infrahyoid musculature, including muscle identification, bulk and function. |
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| Ultrasound for dysphonia | Diagnostic Test | Adult patients who are seen at the Sean Parker Institute for the Voice and are determined to have muscle tension dysphonia will undergo ultrasonography during their visit with laryngology or speech language pathology. |
|
| Day 1 |
| Change in volume of injectate in injection laryngoplasty measured by ultrasound compared to amount injected after procedure and at follow-up. | The volume will be recorded in mL. | Immediately post-intervention and at 4 week follow-up visit |
| Presence, bulk, and function of tongue, suprahyoid, and infrahyoid musculature on ultrasound for patients with and without swallowing complaints. | This is a qualitative outcome measure. Providers will provide a description of the tongue, suprahyoid, and infrahyoid musculature on ultrasound for patients with and without swallowing complaints. | Day 1 |
| Evaluation of suprahyoid musculature on ultrasound for patients with muscle tension dysphonia. | This is a qualitative outcome measure. Providers will provide a description of the suprahyoid musculature on ultrasound for patients with muscle tension dysphonia. | Day 1 |
| ID | Term |
|---|---|
| D003371 | Cough |
| D014826 | Vocal Cord Paralysis |
| D003680 | Deglutition Disorders |
| D055154 | Dysphonia |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007818 | Laryngeal Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D020421 | Vagus Nerve Diseases |
| D003389 | Cranial Nerve Diseases |
| D009422 | Nervous System Diseases |
| D010243 | Paralysis |
| D009461 | Neurologic Manifestations |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D010608 | Pharyngeal Diseases |
| D014832 | Voice Disorders |
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| ID | Term |
|---|---|
| D014463 | Ultrasonography |
| ID | Term |
|---|---|
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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