Does oral nimodipine promote recovery from acute vocal fold paralysis (AVFP)?
Background: AVFP is a common disorder treated by laryngologists. Although previous research in animals suggests benefit, the ability of the anti-hypertensive medication nimodipine to promote functional vocal fold recovery in patients with AVFP is uncertain.
Explore this issue:August 2014
Study design: Prospective open label clinical trial.
Setting: University of Pittsburgh Voice Center.
Synopsis: The investigators followed 40 patients treated with oral nimodipine for AVFP. Seven patients withdrew from the study due to adverse reaction to the medication, and five were lost to follow-up. Of the 28 patients with 30 immobile vocal folds who completed treatment, 18 of the paralyzed folds experienced recovery of purposeful motion (60%). This is noticeably higher than a historical recovery rate of 20%.
These results are exciting and may transform the way AVFP is triaged and treated. The authors should be commended for the potential of this high-impact study, and note that a randomized, placebo-controlled clinical trial is indicated.
Bottom line: The anti-hypertensive calcium channel blocker nimodipine may promote functional recovery in patients with acute onset vocal fold paralysis. An RCT is indicated.
Citation: Rosen CA, Smith L, Young V, Krishna P, Muldoon MF, Munin MC. Prospective investigation of nimodipine for acute vocal fold paralysis. Muscle Nerve. 2014;50:114-118.