Journal of Voice最新文献

{"title":"Office-Based Blue Laser Therapy for Epiglottic Cysts: Case Series and Review of the Literature.","authors":"Abdul-Latif Hamdan, Zeina Maria Semaan, Ibana Carapiperis, Lana Ghzayel, Patrick Abou Raji Feghali, Valerie Sarkis, Ghena Lababidi, Jonathan Abou Chaar, Charbel Rameh, Randa Al Barazi","doi":"10.1016/j.jvoice.2026.03.034","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.03.034","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to report a series of four epiglottic cysts treated with office-based blue laser.</p><p><strong>Methods: </strong>Case series and review of the literature.</p><p><strong>Results: </strong>Four patients, two males and two females diagnosed with epiglottic cyst on laryngeal examination underwent office-based blue laser therapy. The main presenting symptoms included globus sensation, throat clearing and change in voice quality. The laser was used in contact and noncontact mode and a total of 40 to 155 joules was delivered. The tip of the glass fiber was used to open the cyst wall and the mucoid content of the cyst were drained. All patients tolerated the procedure well and the mean tolerance score using the Iowa Satisfaction with Anesthesia Scale was 1.63 ± 0.92. On follow-up, three of four patients had complete disease regression with resolution of their symptoms. One patient was lost for follow-up.</p><p><strong>Conclusion: </strong>Office-based blue laser therapy is a safe and well tolerated treatment alternative to patients who are at risk or refuse general anesthesia. A larger case series with longer follow up periods are needed to establish the recurrence rate following therapy.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic Classification of Functional Dysphonia Using Voc2Vec Speech Representations.","authors":"Kiran Reddy Mittapalle","doi":"10.1016/j.jvoice.2026.03.041","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.03.041","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to develop a machine learning-based automatic classification framework for functional dysphonia using speech representations derived from a pre-trained Voc2Vec model. The proposed system targets three classes: healthy, hyperfunctional dysphonia, and hypofunctional dysphonia.</p><p><strong>Methods: </strong>Experiments were conducted using the VOICED database, which includes speech recordings from healthy individuals and patients with hyperfunctional and hypofunctional dysphonia. Speech signals were preprocessed and segmented, and features were extracted from different transformer layers of a pre-trained Voc2Vec model. A support vector machine (SVM) with a radial basis function kernel was used for classification. The performance of the proposed approach was compared with standard acoustic feature sets, namely IS10 and eGeMAPS. A fivefold speaker-independent cross-validation scheme was employed, and class imbalance was addressed using SMOTE.</p><p><strong>Results: </strong>The proposed Voc2Vec-based system achieved a maximum classification accuracy of 83.37%, outperforming the baseline feature sets (72.31% for eGeMAPS and 65.21% for IS10). Improved class-wise precision, recall, and F1-scores were observed across all classes. Statistical analysis using the Wilcoxon signed-rank test confirmed that the performance improvements were significant (P < 0.05).</p><p><strong>Conclusion: </strong>The results demonstrate that Voc2Vec-based representations effectively capture relevant phonatory characteristics for functional dysphonia classification. The proposed approach provides a non-invasive and reliable framework for distinguishing between healthy, hyperfunctional, and hypofunctional voices, with potential applications in clinical decision support systems.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy and Safety of Systemic Treatment for Managing Recurrent Respiratory Papillomatosis: A Systematic Review and Meta-analysis.","authors":"Mohammed H Baali, Abdulaziz A Neazy, Wahaj A Altalhi, Sara A Almansour, Mohammed I Almohizea, Manal A Bukhari","doi":"10.1016/j.jvoice.2026.03.028","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.03.028","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical treatment remains the cornerstone of recurrent respiratory papillomatosis (RRP) management; however, aggressive disease often requires frequent procedures with cumulative morbidity. Contemporary systemic options now include systemic bevacizumab and human papillomavirus (HPV)-specific immunotherapies, with immune checkpoint inhibition under investigation. We systematically reviewed the efficacy and safety of systemic therapies for juvenile- and adult-onset RRP, emphasizing current clinician-relevant treatment options.</p><p><strong>Methods: </strong>We comprehensively searched PubMed, Scopus, Web of Science, and the Cochrane Library from inception until January 2026. The included studies evaluated any available systemic treatment for managing adult or juvenile-onset RRP. The main outcomes were complete remission, partial response, and adverse events. All the data analyses were performed using STATA 18 BE.</p><p><strong>Results: </strong>We included 35 studies comprising 925 patients. In juvenile-onset RRP, pooled complete remission with systemic bevacizumab was 60% (95% CI 34-87%), and pooled partial response was 46% (95% CI 21-71%). In adult-onset RRP, pooled complete remission with systemic bevacizumab was 44% (95% CI 26-62%), and pooled partial response was 61% (95% CI 43-79%). The most frequently reported bevacizumab adverse events were hypertension (40%), proteinuria (26%), and epistaxis (22%). HPV-specific immunotherapies (including FDA-approved zopapogene imadenovec-drba [Papzimeos; PRGN-2012] for adults and investigational INO-3107) and PD-1/PD-L1-directed therapies demonstrated encouraging early-phase activity but were too heterogeneous for quantitative pooling.</p><p><strong>Conclusion: </strong>Systemic bevacizumab remains the most mature systemic option with consistent real-world evidence and published dosing guidance. HPV-specific immunotherapy has recently transformed adult RRP management with an FDA-approved, short-course treatment option; ongoing studies will clarify optimal sequencing with bevacizumab and the role of checkpoint inhibition.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Experimental Study of the Fusion of Expression and Movement on the Perception and Emotional Communication of Vocal Performances within the Framework of Embodied Music Cognition - Using \"Partita for 8 Voices\" as the Medium.","authors":"Chunlin Wu","doi":"10.1016/j.jvoice.2026.04.007","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.04.007","url":null,"abstract":"<p><strong>Background: </strong>Embodied cue integration through visible movement and vocal performance is hypothesized to modulate audience emotional engagement. This study aimed to quantify perceptual, physiological, and gaze-based effects of movement-voice integration compared to static delivery in a controlled experimental setting.</p><p><strong>Methods: </strong>Eighty adults were randomly assigned to experimental (n = 40) or control (n = 40) arms. Stimuli comprised integrated movement-voice and static voice-only conditions. Measures included GEMS-9, SIPE-7, heart rate variability (root mean square of successive differences, low-frequency power [LF], high-frequency power [HF], LF/HF), skin conductance (tonic skin conductance level, skin conductance response amplitude), and eye-tracking metrics (fixation counts, durations, proportional gaze). Mixed-effects models, difference-in-differences, and correlation analyses were conducted using R 4.3.2, with covariate-adjusted sensitivity analyses performed on excluded data subsets.</p><p><strong>Results: </strong>Movement yielded greater emotional intensity (+0.82 ± 0.36 vs. +0.12 ± 0.29, P = 0.002), positive affect (+0.65 ± 0.31 vs. +0.09 ± 0.27, P = 0.004), and expressiveness (+1.12 ± 0.48 vs. +0.18 ± 0.39, P = 0.001). LF power increased by +140 ± 65 vs. +20 ± 58 (P = 0.006) and HF power by +118 ± 54 vs. +15 ± 49 (P = 0.007), with LF/HF ratio reduced by -0.14 ± 0.07 vs. -0.02 ± 0.06 (P = 0.010). Face fixations rose by +8.2 ± 2.9 vs. +1.1 ± 2.5 (P = 0.001) with proportional gaze to face increasing by +4.6 ± 1.9 vs. +0.6 ± 1.6 (P = 0.002). Sensitivity analyses confirmed robustness (P = 0.011-0.019).</p><p><strong>Conclusion: </strong>Movement-voice integration produces measurable perceptual, autonomic, and attentional gains over static delivery.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the Transtheoretical Model of Behavior Change Framework to Evaluate Readiness and Barriers to Voice Therapy Among School Teachers.","authors":"Sushmitha Murali, Prakash Boominathan, Lakshmi Venkatesh, Shuba Kumar","doi":"10.1016/j.jvoice.2026.04.021","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.04.021","url":null,"abstract":"<p><strong>Background: </strong>Voice therapy plays an important role in maintaining vocal health among school teachers, who are at high risk of developing voice disorders due to prolonged and excessive voice use. Despite the benefits, the adoption and utilization of voice therapy among school teachers is not widespread. Several barriers, including poor/no awareness, time constraints, financial limitations, and institutional support, hinder participation. As a first step towards improving voice therapy adoption, this study adapts and integrates behavior change theories to propose a context-specific conceptual framework for assessing readiness and barriers to voice therapy among school teachers.</p><p><strong>Aim: </strong>The study aimed to review and adapt behavior change theories to develop a context-specific conceptual framework to systematically understand the barriers and readiness to voice therapy.</p><p><strong>Method: </strong>The Transtheoretical Model of Change was selected as the primary framework to evaluate the stages of behavior change in therapy adoption. To enhance specificity, additional models such as the Health Belief Model, Force Field Theory, Process Stage Model, PRECEDE-PROCEED Model, Protection Motivation Theory, Social Cognitive Theory, Mowrer Two Factor Theory, Psychological Cascade Model, Theory of Planned Behavior, Self-Determination Theory, and COM-B Model (Capability, Opportunity, Motivation and Behaviour) were reviewed to identify and integrate suitable constructs. A description of the framework selection process and an analysis of each selected theoretical model are provided.</p><p><strong>Results: </strong>The adapted framework integrates stage-based behavioral progression with cognitive, emotional, motivational, and organizational determinants embedded within each readiness stage. The framework categorizes teachers by their readiness stage and provides a basis for stage-matched intervention planning.</p><p><strong>Conclusion: </strong>The developed framework provides a structured approach for evaluating barriers and readiness to voice therapy among school teachers. The framework also provides a theoretical foundation for future research and development of interventions aimed at improving uptake of voice therapy and long-term vocal health in school teachers.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women with Vocal Fold Nodules: Analysis of Voice Quality and Vocal Self-Perception.","authors":"Luiza Pereira Duque Meinberg, Fabiana Andrade Penido, Karine Valéria Gonçalves de Oliveira, Marco Aurélio Rocha Santos, Ana Cristina Côrtes Gama","doi":"10.1016/j.jvoice.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.03.009","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the voices of women with vocal fold nodules and those of a control group through acoustic assessment (multiparametric and cepstral measures), auditory- and self-perceptual assessments.</p><p><strong>Methods: </strong>This observational analytical case-control study included 21 women with no laryngeal pathologies (CG) and 19 women with vocal fold nodules (NG), aged between 21 and 58 years. All participants underwent videolaryngoscopy. The selection criteria excluded participants from both groups who had allergic crises and/or colds, self-reported pregnancy, or menstruation on the day of data collection. Acoustic assessment was performed using sustained vowel [a], continuous speech, and specific phonation tasks. Cepstral measures (cepstral peak prominence (CPP) and smoothed CPP (CPPs)) and multiparametric acoustic indices (Acoustic Voice Quality Index, Acoustic Breathiness Index (ABI), and Dysphonia Severity Index (DSI)) were extracted using the Praat software. For auditory-perceptual assessment, the parameters of overall grade of dysphonia (G), roughness (R), and breathiness (B) were used, while vocal self-assessment was conducted using the Voice Symptom Scale (VoiSS) questionnaire. The statistical tests applied included the Anderson-Darling test, Student's t-test, Mann-Whitney U test, and chi-square test, with a significance level of 5%.</p><p><strong>Results: </strong>Significant differences were found between the groups in ABI (P = 0.013), DSI (P = 0.022) e CPPs of the vowel (P = 0.016), with more altered values observed in the NG. In the perceptual-auditory evaluation of the voices, the NG showed a higher occurrence of moderate breathy voice quality than the CG, with a statistically significant difference (P = 0.052). Regarding vocal self-perception, the NG obtained higher scores in the Limitation, Emotional, and Total Score subscales of the VoiSS, with statistically significant results (P < 0.000).</p><p><strong>Conclusion: </strong>The presence of vocal fold nodules in women is associated with breathiness in voice quality along with alterations in the acoustic indices ABI, DSI, and CPPs of the sustained vowel, and a negative effect on vocal functionality.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to Updated Acoustic Normative Data Through the Lifespan: A Scoping Review, 39 (4) (2025) 1130.e1-1130.e18.","authors":"S A K Kent, T L Fletcher, A Morgan, M E Morton, R J Hall, M J Sandage","doi":"10.1016/j.jvoice.2026.04.041","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.04.041","url":null,"abstract":"","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Wound Healing Dynamics and Tissue Remodeling After Minimally Invasive Voice Preservation Techniques With Implications for Functional Outcomes Racial Disparities and Access in Professional Singers: A Literature Review.","authors":"Kerol Faltas, Marc Faltas, Precious Ochuwa Imokhai, Maria Abou Taka, Shivashri Anananthamurugan, Satyam K Singh, Amanda Brooks","doi":"10.1016/j.jvoice.2026.02.001","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.02.001","url":null,"abstract":"<p><p>Minimally invasive voice-preservation techniques, including microlaryngoscopy, phonosurgery, and office-based regenerative interventions, have revolutionized the management of benign and early-stage laryngeal disorders by minimizing fibrosis and preserving phonatory function. However, the long-term (>6 months) wound healing and extracellular matrix (ECM) remodeling dynamics that determine sustained vocal outcomes remain poorly understood, particularly among professional singers who experience high vibratory demand. Moreover, African American and minority singers continue to face significant barriers to specialty laryngology care, underrepresentation in research cohorts, and disparities in insurance coverage, creating inequities in both access and postoperative outcomes. This review synthesizes evidence on chronic wound healing and ECM remodeling following minimally invasive voice-preservation procedures, emphasizing histologic integration, molecular mediators of fibrosis, and correlations with objective (dysphonia severity index, vocal extent measure, and maximum phonation time) and subjective (voice handicap index, singing voice handicap index) recovery metrics. It also examines racial and socioeconomic inequities in laryngeal care among professional voice users. Our method for this research was to use PubMed, JStor, Web of Science, and Cochrane Library databases starting from 2000. The study will include randomized controlled trials and observational cohorts and case series with ten or more patients and previous systematic reviews that focus on wound healing and functional outcomes and access disparities. Two reviewers will conduct independent screening and data extraction, while thematic synthesis will be used to organize existing evidence and identify areas where more research is needed. Existing studies demonstrate consistent short-term improvement in acoustic and perceptual metrics but limited histologic data beyond 9-12 months. Available human biopsy findings reveal fibroblast infiltration and partial ECM integration (eg, silk-hyaluronic acid hydrogels, adipose-derived stromal vascular fraction therapy), yet lack quantitative analysis of collagen I/III ratios, elastin content, and viscoelastic restoration. Professional singers remain largely excluded from histologic or biomechanical cohorts. Persistent racial and geographic disparities further limit access to specialized voice-preservation surgery and longitudinal follow-up. Long-term remodeling after minimally invasive voice-preservation procedures remains underexplored, with crucial gaps in linking tissue biomechanics to clinical outcomes and health equity. This review identifies priorities for multicenter, demographically inclusive research integrating molecular, histologic, and performance-based endpoints to advance equitable, evidence-based voice care for professional singers and high-demand voice users.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Dye Distribution in Cadaveric Supraglottic Injections: Elucidating the Mechanism of Action for Supraglottic Botulinum Neurotoxin Injection.","authors":"Hyung-Jin Lee, In-Beom Kim, Bo Hae Kim, Ji-Hyun Lee","doi":"10.1016/j.jvoice.2026.04.016","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.04.016","url":null,"abstract":"<p><p>Supraglottic botulinum neurotoxin (BoNT) injections have been introduced as an alternative treatment for adductor spasmodic dysphonia (AdSD) to reduce adverse effects associated with direct intramuscular vocal fold injections. However, the anatomical distribution pattern of BoNT following supraglottic injection and the predominantly affected intrinsic laryngeal muscles have not yet been clearly elucidated, owing to a lack of detailed anatomical investigations. Thirteen fresh human cadavers (seven males and six females; mean age, 77.0 years) were included in this study. After harvesting the larynx, a supraglottic injection was performed under direct anatomical visualization using a blue dye as a tracer. Injection volumes of 0.4 mL and 0.2 mL were administered bilaterally. Following passive simulation of laryngeal adduction and abduction, specimens were frozen at -80 °C and sectioned coronally. Dye distribution was analyzed with a primary focus on the thyroarytenoid (TA) muscle complex, including the aryepiglottic muscle fibers, main TA muscle, vocalis muscle, and diffusion to other intrinsic laryngeal muscles. In all specimens, the dye remained confined to the supraglottic soft tissues, with no extension to the structures outside the larynx. At the muscular level, the dye involvement was limited to the TA muscle complex. The dye was consistently observed along the aryepiglottic muscle fibers and extended toward the main TA muscle. Partial intramuscular spread into the main TA muscle was identified in 50% of specimens in both injection volume groups (0.4 and 0.2 mL). Minimal extension into the vocalis muscle was observed in 33% of specimens. In contrast, no dye diffusion into the lateral cricoarytenoid, posterior cricoarytenoid, or interarytenoid muscles was observed in any of the specimens. Although the extent of dye spread varied according to injection volume, the pattern of muscle involvement was similar between the two groups. The mean distance from the supraglottic injection site to the TA muscle was 12.9 ± 1.7 mm. Supraglottic BoNT injections preferentially involve the thyroarytenoid muscle complex, with limited extension into the vocalis muscle and no diffusion into the other intrinsic laryngeal muscles. These anatomical findings provide a plausible explanation for the balance between therapeutic efficacy and tolerability reported with supraglottic BoNT injection in adductor spasmodic dysphonia and support its relative safety with respect to unintended muscle paralysis.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Safety of Platelet-Rich Plasma Injection for Vocal Fold Scar and Sulcus Vocalis: A Systematic Review and Meta-Analysis.","authors":"Rami Saade, Mia Harb, Dana Swaidan, Anna Karena Issa, Anita El Hajj, Georges Ziade","doi":"10.1016/j.jvoice.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.04.010","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) has emerged as a regenerative therapy aimed at improving tissue healing and vocal fold function; however, clinical evidence remains limited. This systematic review and meta-analysis aim to evaluate the effectiveness and safety of PRP injection for the treatment of vocal fold scar and sulcus vocalis.</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science were searched from inception until October 25, 2025, to identify studies evaluating PRP injection for vocal fold scar or sulcus vocalis. Outcomes included patient-reported voice disability, perceptual voice assessment, acoustic and functional measures, subjective improvement outcomes, and complications. Random-effects models were used to pool effect estimates. Risk of bias was assessed using study design-specific tools.</p><p><strong>Results: </strong>Nine studies comprising 353 patients were included. PRP injection was associated with a significant improvement in voice handicap index-10 scores (mean difference -6.74, 95% confidence interval -9.88 to -3.59), although substantial heterogeneity was observed (I² = 77.44%). Significant improvements were also observed in most GRBAS perceptual voice domains and vocal fatigue index scores. Cepstral spectral index of dysphonia scores improved significantly, whereas no significant changes were observed in jitter, fundamental frequency, or maximum phonation time. A substantial proportion of patients reported improvement in voice quality, ease of phonation, and stroboscopic findings following PRP injection. Reported complications were predominantly mild and transient. Overall evidence quality was limited by small sample sizes, heterogeneity in treatment protocols, and predominance of non-randomized studies.</p><p><strong>Conclusions: </strong>PRP injection for vocal fold scar and sulcus vocalis may be associated with improvements in patient-reported voice disability and perceptual voice quality, with a generally favorable safety profile. However, evidence for objective acoustic and functional outcomes remains inconsistent, and the overall quality of evidence is limited, precluding definitive conclusions. Further well-designed randomized trials are needed to establish an accurate efficacy and safety profile.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}