AzTrials
AzTrials

Voice ChangePhase 2NCT05732883

The Use of Dexamethasone in Total Thyroidectomy to Improve Voice Outcome and Hypocalcaemia

A Phase 2 study testing Dexamethasone and Normal saline in people with Voice Change and Hypocalcemia, run by Tseung Kwan O Hospital, Hong Kong at 1 site in Hong Kong.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

Thyroidectomy is a standard procedure for benign and malignant pathologies of the thyroid gland. Each year, some 100 total thyroidectomies are performed in Kowloon East Cluster, Hospital Authority, Hong Kong. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Voice Change, Hypocalcemia
What is being tested?
Dexamethasone and Normal saline
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
100 participants
Where
1 siteHong Kong
Study dates
1 Jul 2024to 30 Sep 2026
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Aged 18 or above
  • Patients undergoing total thyroidectomy for benign pathologies
  • MNG
  • Toxic nodular goitre
  • Graves' disease

Who cannot join

  • Non-communicable patients
  • Patients contraindicated for steroid (DM, Hepatitis carrier, Tuberculosis, peptic ulcer disease)
  • Patients contraindicated for analgesics including Panadol, Celebrex, Tramadol or Levobupivacaine
  • Malignant thyroid disease
  • Patients with previous thyroid surgery, or neck surgery
  • Pre-existing hoarseness of voice of any cause or pre-existing vocal cord palsy
Show all 9Show fewer
  • Pregnancy / Lactating female patients
  • Pre-existing renal disease / autoimmune disease on steroids
  • Patients who require steroid cover during operation e.g. hydrocortisone perioperatively

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site, 1 recruiting
  • Department of Otorhinolaryngology, Head and Neck Surgery, United Christian Hospital and Tseung Kwan O Hospital

    Hong Kong

    Zenon Yeung, MbChB, +852-39495442, dr.zenon.yeung@gmail.com

    Thomas Hui, BSc, +852-39493549, hsc526@ha.org.hk

    Recruiting

Other trials in Hong Kong

About this study

Thyroidectomy is a standard procedure for benign and malignant pathologies of the thyroid gland. Each year, some 100 total thyroidectomies are performed in Kowloon East Cluster, Hospital Authority, Hong Kong. Total thyroidectomy is associated with voice dysfunction and temporary hypocalcaemia in up to 80% and 50%, respectively. Previous study from our institute showed a 3% rate of permanent vocal cord palsy and 16% of permanent hypoparathyroidism requiring calcium and/or vitamin D supplements. The use of dexamethasone has been studied in the past in total thyroidectomy patients and has been shown to be safe and effective in improving post-operative nausea and vomiting. No complications or drug related side effects were associated with a single dose of steroid. Recent studies have also shown that Dexamethasone is effective in improving voice outcome and hypocalcaemia in thyroidectomy patients. The investigators aim to study the effect of Dexamethasone in post-operative voice outcome and hypocalcaemia. Objective assessment of the vocal cords during phonation will be performed pre-operative and post-operatively. Serum Calcium level will be monitored.

Read the detailed description

This is a multi-specialty, double-blind, randomized, placebo-controlled trial involving the Departments of Surgery in United Christian Hospital, Tseung Kwan O Hospital and Department of Ear, Nose and Throat, United Christian Hospital and Tseung Kwan O Hospital, Kowloon East Cluster. The primary objective is to investigate the effect of Dexamethasone in post-operative voice outcome and hypocalcaemia in total thyroidectomy patients. The secondary outcome aims to investigate the mechanism of voice dysfunction in thyroidectomy patients using objective assessment tools.

To streamline the practice among various departments and to minimize any potential confounders, the peri-operative anaesthetic and post-operative analgesic protocols are standardized. The surgical techniques are also standardized using capsular dissection with positive identification and preservation of the recurrent laryngeal nerve.

Patient's voice and vocal cord mobility will be assessed pre-operatively and post-operatively. Objective assessment of the vocal cord will be carried out using video stroboscopy to document the mobility, waveform and vibration, symmetry and any arytenoid abnormality. Subjective and objective assessment of the voice outcome will be conducted by speech therapists using standardized voice assessment protocol. The trend of hypocalcaemia (Calcium level and parathyroid hormone level) will be monitored and correlated with the use of Dexamethasone. Possible side effect (e.g. wound infection) from the use of Dexamethasone will be analysed

Being tested
Dexamethasone, Normal saline
Keywords
Voice dysfunction, Hoarseness of Voice, Vocal cord palsy, Hypocalcemia, Hypoparathyroidism, Thyroidectomy, Dexamethasone, Steroid
Medical subject headings
Dysphonia, Hypocalcemia, Hoarseness, Vocal Cord Paralysis, Hypoparathyroidism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT05732883
Study groupRoleWhat they receive
Dexamethasone groupExperimentalOne dose of 8mg in 2ml Dexamethasone will be given
Receives: Drug: Dexamethasone
Placebo groupPlacebo comparatorOne dose of 2ml 0.9% Normal saline will be given
Receives: Drug: Normal saline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Post-operative calcium and parathyroid hormone level on POD1

    Serum calcium and parathyroid hormone level will be monitored

    Measured: Post-op 1 day

  2. Post-operative calcium and parathyroid hormone level after 3 months post-op

    Serum calcium and parathyroid hormone level will be monitored

    Measured: Post-op 3 months

  3. Post-operative calcium and parathyroid hormone level after 6 months post-op

    Serum calcium and parathyroid hormone level will be monitored

    Measured: Post-op 6 months

  4. Voice Handicap Index (VHI-10)

    Subjective voice assessment consisting of 10 questions. Each question 0-4 score

    Measured: Post-op 1 week

  5. Voice Handicap Index (VHI-10)

    Subjective voice assessment consisting of 10 questions. Each question 0-4 score

    Measured: Post-op 3 months

  6. Voice Handicap Index (VHI-10)

    Subjective voice assessment consisting of 10 questions. Each question 0-4 score

    Measured: Post-op 6 months

  7. Perceptual Evaluation: Cantonese Perceptual Evaluation of Voice (CanPEV)

    Objective voice assessment consisting of 10 questions. Each question 1-10 score. 1 being normal and 10 being the most severe voice dysfunction

    Measured: Post-op 1 week

  8. Perceptual Evaluation: Cantonese Perceptual Evaluation of Voice (CanPEV)

    Objective voice assessment consisting of 10 questions. Each question 1-10 score. 1 being normal and 10 being the most severe voice dysfunction

    Measured: Post-op 3 months

  9. Perceptual Evaluation: Cantonese Perceptual Evaluation of Voice (CanPEV)

    Objective voice assessment consisting of 10 questions. Each question 1-10 score. 1 being normal and 10 being the most severe voice dysfunction

    Measured: Post-op 6 months

  10. Acoustic Evaluation

    Instruct patient to sustain vowel /a/ and to read aloud the Hong Kong passage at a comfortable pitch and loudness level for about 3-5 seconds. Keep a distance of 15cm from the microphone for recording. Highlight the middle 3 seconds for analysis. To assess the fundamental frequency (Hz) and performance (dB)

    Measured: Post-op 1 week

  11. Acoustic Evaluation

    Instruct patient to sustain vowel /a/ and to read aloud the Hong Kong passage at a comfortable pitch and loudness level for about 3-5 seconds. Keep a distance of 15cm from the microphone for recording. Highlight the middle 3 seconds for analysis. To assess the fundamental frequency (Hz) and performance (dB)

    Measured: Post-op 3 months

  12. Acoustic Evaluation

    Instruct patient to sustain vowel /a/ and to read aloud the Hong Kong passage at a comfortable pitch and loudness level for about 3-5 seconds. Keep a distance of 15cm from the microphone for recording. Highlight the middle 3 seconds for analysis. To assess the fundamental frequency (Hz) and performance (dB)

    Measured: Post-op 6 months

  13. Aerodynamic Evaluation (Maximum sustained phonation)

    Instruct patient to sustain vowel /a/ at a comfortable pitch and loudness level for as long as possible after taking a deep breath. Recorded in seconds

    Measured: Post-op 1 week

  14. Aerodynamic Evaluation (Maximum sustained phonation)

    Instruct patient to sustain vowel /a/ at a comfortable pitch and loudness level for as long as possible after taking a deep breath. Recorded in seconds

    Measured: Post-op 3 months

  15. Aerodynamic Evaluation (Maximum sustained phonation)

    Instruct patient to sustain vowel /a/ at a comfortable pitch and loudness level for as long as possible after taking a deep breath. Recorded in seconds

    Measured: Post-op 6 months

Secondary outcomes (25)
  1. Calcium and Rocaltrol requirement

    The required dosage of Calcium Carbonate and Rocaltrol will be documented

    Measured: Post-op 1 week

  2. Calcium and Rocaltrol requirement

    The required dosage of Calcium Carbonate and Rocaltrol will be documented

    Measured: Post-op 3 months

  3. Calcium and Rocaltrol requirement

    The required dosage of Calcium Carbonate and Rocaltrol will be documented

    Measured: Post-op 6 months

  4. Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

    Number of participants experiencing side effects from Dexamethasone will be documented

    Measured: Post-op 1 week

  5. Stroboscopic Assessment (Vocal Fold Edge)

    Score 1-5 (1 - Smooth and straight; 5 - Rough and irregular)

    Measured: Post-op 1 week

  6. Stroboscopic Assessment (Vocal Fold Edge)

    Score 1-5 (1 - Smooth and straight; 5 - Rough and irregular)

    Measured: Post-op 3 months

  7. Stroboscopic Assessment (Vocal Fold Edge)

    Score 1-5 (1 - Smooth and straight; 5 - Rough and irregular)

    Measured: Post-op 6 months

  8. Stroboscopic Assessment (Glottic Closure)

    Grading 1-7 (1. Complete 2. Anterior chink 3. Irregular 4. Bowing 5.Posterior chink 6. Hourglass 7 Incomplete)

    Measured: Post-op 1 week

  9. Stroboscopic Assessment (Glottic Closure)

    Grading 1-7 (1. Complete 2. Anterior chink 3. Irregular 4. Bowing 5.Posterior chink 6. Hourglass 7 Incomplete)

    Measured: Post-op 3 months

  10. Stroboscopic Assessment (Glottic Closure)

    Grading 1-7 (1. Complete 2. Anterior chink 3. Irregular 4. Bowing 5.Posterior chink 6. Hourglass 7 Incomplete)

    Measured: Post-op 6 months

  11. Stroboscopic Assessment (Vertical Level of Approximation)

    1 - Equal 2 - Right lower 3 - Left lower 4 - Questionable

    Measured: Post-op 1 week

  12. Stroboscopic Assessment (Vertical Level of Approximation)

    1 - Equal 2 - Right lower 3 - Left lower 4 - Questionable

    Measured: Post-op 3 months

  13. Stroboscopic Assessment (Vertical Level of Approximation)

    1 - Equal 2 - Right lower 3 - Left lower 4 - Questionable

    Measured: Post-op 6 months

  14. Stroboscopic Assessment (Amplitude)

    1 - Normal 2 - Slightly decreased 3 - Moderately decreased 4 - Severely decreased 5 - No visible movement

    Measured: Post-op 1 week

  15. Stroboscopic Assessment (Amplitude)

    1 - Normal 2 - Slightly decreased 3 - Moderately decreased 4 - Severely decreased 5 - No visible movement

    Measured: Post-op 3 months

  16. Stroboscopic Assessment (Amplitude)

    1 - Normal 2 - Slightly decreased 3 - Moderately decreased 4 - Severely decreased 5 - No visible movement

    Measured: Post-op 6 months

  17. Stroboscopic Assessment (Mucosal wave)

    1 - Normal 2 - Slightly decreased 3 - Moderately decreased 4 - Severely decreased 5 - Absent

    Measured: Post-op 1 week

  18. Stroboscopic Assessment (Mucosal wave)

    1 - Normal 2 - Slightly decreased 3 - Moderately decreased 4 - Severely decreased 5 - Absent

    Measured: Post-op 3 months

  19. Stroboscopic Assessment (Mucosal wave)

    1 - Normal 2 - Slightly decreased 3 - Moderately decreased 4 - Severely decreased 5 - Absent

    Measured: Post-op 6 months

  20. Stroboscopic Assessment (Regularity)

    1 - Regular 2 - Sometimes irregular 3 - Most irregular 4 - Always irregular

    Measured: Post-op 1 week

  21. Stroboscopic Assessment (Regularity)

    1 - Regular 2 - Sometimes irregular 3 - Most irregular 4 - Always irregular

    Measured: Post-op 3 months

  22. Stroboscopic Assessment (Regularity)

    1 - Regular 2 - Sometimes irregular 3 - Most irregular 4 - Always irregular

    Measured: Post-op 6 months

  23. Stroboscopic Assessment (Ventricular folds)

    Movement - 1.Normal 2.Slight compress 3.Moderate compress 4.Full compress

    Measured: Post-op 1 week

  24. Stroboscopic Assessment (Ventricular folds)

    Movement - 1.Normal 2.Slight compress 3.Moderate compress 4.Full compress

    Measured: Post-op 3 months

  25. Stroboscopic Assessment (Ventricular folds)

    Movement - 1.Normal 2.Slight compress 3.Moderate compress 4.Full compress

    Measured: Post-op 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Feb 2023
  2. Study start1 Jul 2024
  3. Primary completion30 Jun 2026 (estimated)
  4. Study completion30 Sep 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Multi-specialty, double-blind, randomized, placebo-controlled trial
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05732883
Sponsor's protocol ID
KC/KE-22-0022/FR-4
Status last verified
Jul 2024
First submitted
27 Dec 2022
Last updated
9 Jul 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Dexamethasone and Normal saline in people with Voice Change and Hypocalcemia, run by Tseung Kwan O Hospital, Hong Kong at 1 site in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 9 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Cherrie Ng (+85235051409, cherrieng@ent.cuhk.edu.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Post-operative calcium and parathyroid hormone level on POD1 (time frame: Post-op 1 day). The study lists 15 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jul 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in