Prospective investigation of nimodipine for acute vocal fold paralysis

Muscle Nerve. 2014 Jul;50(1):114-8. doi: 10.1002/mus.24111. Epub 2014 May 5.

Abstract

Introduction: Nimodipine has been shown to be beneficial for recovery from acute vocal fold paralysis (AVFP) in an animal model.

Methods: prospective, open-label trial of patients with AVFP was performed using nimodipine. Consecutive patients were evaluated and offered nimodipine therapy.

Results: Fifty-three patients were considered for treatment with nimodipine. Thirteen did not qualify for inclusion, 5 were lost to follow-up, and 7 had side effects requiring cessation of treatment. Thus 28 patients (30 paralyzed vocal folds) were analyzed. Eighteen of the paralyzed vocal folds experienced recovery of purposeful motion (60%). Historical controls and laryngeal electromyography meta-analysis suggest no more than a 20% recovery rate from AVFP.

Conclusions: This open label study using nimodipine for treatment of AVFP demonstrates tripling of the recovery rate of vocal fold motion compared with historical controls. Further study in a randomized, controlled manner is warranted.

Keywords: laryngeal electromyography; laryngeal muscle innervation; nerve regeneration/drug effects; nimodipine; vocal cord paralysis.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / therapeutic use*
  • Electromyography
  • Female
  • Humans
  • Larynx / physiopathology
  • Male
  • Middle Aged
  • Motor Neurons / physiology
  • Muscle Fibers, Skeletal / physiology
  • Nimodipine / adverse effects
  • Nimodipine / therapeutic use*
  • Prognosis
  • Prospective Studies
  • Treatment Outcome
  • Vocal Cord Paralysis / diagnosis
  • Vocal Cord Paralysis / drug therapy*

Substances

  • Calcium Channel Blockers
  • Nimodipine