Journal of Voice最新文献

{"title":"Relationships Between Objective Laryngostroboscopic Measures and Patient Ratings With Treatment Recommendations for Patients With Presbylarynges.","authors":"Sheila V Stager, Adam Ciarleglio, Steven A Bielamowicz","doi":"10.1016/j.jvoice.2025.09.037","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.037","url":null,"abstract":"<p><strong>Objectives/hypotheses: </strong>To use principal component analysis (PCA), including objective laryngostroboscopic measures and patient-reported quality of life and symptom severity ratings from initial evaluations of patients with presbylarynges as an initial step toward developing a framework for streamlining specific treatment recommendations, especially for those who might benefit initially from procedural intervention (PI), as well as patient compliance with those recommendations.</p><p><strong>Research design: </strong>The design was retrospective, analytical, observational, and cross-sectional.</p><p><strong>Methods: </strong>One hundred eighteen patients with presbylarynges evaluated by one laryngologist participated. Variables included normalized glottal gap area (NGGA), normalized true vocal fold width (NTVFW), total bowing index (Total BI) from single laryngostroboscopic images, multi-item ratings [Glottal Function Index (GFI), Voice-Related Quality of Life (V-RQOL)], single-item ratings (effort, weakness, hoarseness, swallowing, and breathing), and age. Associations between variables and treatment recommendation were assessed using bivariate tests followed by multinomial logistic regression, and between variables and compliance using bivariate tests followed by binomial logistic regression.</p><p><strong>Results: </strong>V-RQOL, GFI, effort, weakness, and hoarseness significantly differed between treatment groups. More severe ratings of GFI, V-RQOL, effort, weakness, and hoarseness were associated with greater odds of either intervention being recommended over observation. More severe hoarseness ratings were associated with greater odds of recommending PIs over voice therapy (VT). Two principal components (PC1, PC2) were revealed. PC1 represented patient satisfaction with voice quality and less severe vocal symptoms. PC2 represented laryngeal impairment. Using a multivariable logistic model (PC1, PC2, and sex), lower values of PC1 and being male were associated with greater odds of being recommended for either intervention compared with observation. None of the predictors considered were significantly associated with compliance.</p><p><strong>Conclusions: </strong>This initial attempt using data from a single clinic found significant differences in patient ratings between treatment options and significant associations between variables associated with treatment recommendation. The associations were ultimately not predictive for either treatment recommendations or compliance for patients with presbylarynges.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314007","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":"Do-It-Yourself Voice Acoustic Analysis: A Companion to the DIY Voice Dosimeter Device.","authors":"Pasquale Bottalico, Charles J Nudelman, Yehya Sleiman Tellawi, Clarion Mendes","doi":"10.1016/j.jvoice.2025.09.032","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.032","url":null,"abstract":"<p><strong>Purpose: </strong>Voice acoustic analysis informs both scientific research and clinical voice rehabilitation. Adopting voice dosimetry would expand the use of acoustic measurement methods to collect data in the daily lives of individuals with voice disorders. In this editorial article, instructions for an open access, easy-to-use, and automated voice acoustic analysis software are provided. An implementation of this do-it-yourself (DIY) Voice Acoustic Analysis software is also provided.</p><p><strong>Method: </strong>The DIY Voice Acoustic Analysis software was developed using Python. Key acoustic voice parameters are included: sound pressure level (SPL), fundamental frequency, cepstral peak prominence (CPP), and vocal doses. Further, this software was implemented to analyze voice recordings from a university professor who wore a previously developed DIY Voice Dosimeter device for the duration of a 70-minute lecture.</p><p><strong>Results: </strong>The DIY Voice Acoustic Analysis software is available at https://github.com/SpAA-LAB/Dosimetry-App, and instruction videos are further available at that link. The present article demonstrates the software using the voice recordings from the professor.</p><p><strong>Conclusion: </strong>The DIY Voice Acoustic Analysis software is a tool for accessible voice measurement and is especially well-suited to be implemented in conjunction with the DIY Voice Dosimeter device.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309760","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":"IgG4-Related Disease With Larynx Involvement: A Case Report and Literature Review.","authors":"Mingyuan Ouyang, Yijun Dong, Hanwen Zhu, Juanjuan Hu, Hui Yang","doi":"10.1016/j.jvoice.2025.09.028","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.028","url":null,"abstract":"<p><p>IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder with diverse organ involvement. Laryngeal involvement is exceptionally rare and easily misdiagnosed due to its non-specific symptoms and tumor-like appearance. We report a unique case of a 60-year-old woman who presented with progressive dyspnea and was ultimately diagnosed with laryngeal IgG4-RD after multiple biopsies. Imaging revealed additional asymptomatic lesions in the palatine tonsils, subcutaneous tissue, ribs, and lymph nodes. Histology confirmed dense IgG4-positive plasma cell infiltration in the laryngeal lesion, and serum IgG4 levels were markedly elevated. The patient responded well to staged CO₂ laser surgeries and systemic glucocorticoid therapy. This case emphasizes the importance of considering IgG4-RD in patients with unexplained upper airway obstruction and highlights the value of early multidisciplinary evaluation and timely intervention.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304180","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":"Assessing Injectate Volume in Injection Laryngoplasty Using Low-Cost Handheld Ultrasonography: Feasibility Study in an Ex Vivo Porcine Model.","authors":"Mark Lee, Christine M Clark, Sarah R Kervin, Eunice Baik, Anaïs Rameau","doi":"10.1016/j.jvoice.2025.09.036","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.036","url":null,"abstract":"<p><strong>Objectives/hypotheses: </strong>To evaluate the utility of low-cost handheld ultrasound in measuring volumes of injected material in injection laryngoplasty (IL) using an ex vivo porcine model.</p><p><strong>Study design: </strong>Feasibility study.</p><p><strong>Methods: </strong>Two different injection volumes (0.375 and 0.75 mL) and two types of materials (hyaluronic acid (HA) and calcium hydroxyapatite (CaHA)) were injected under direct visualization into porcine vocal folds. Seven replicates were performed for each of the four experimental groups. Cross-sectional longest and shortest dimensions were measured with ultrasound in the paramedian position. The correlation between injected volume and measured cross-sectional area by material type was assessed by ANCOVA.</p><p><strong>Results: </strong>Injections of HA and CaHA into porcine vocal folds were able to be observed with US. Measured cross-sectional area significantly increased with greater volumes of injectate (0.375 mL: 0.29 ± 0.11 cm², 0.750 mL: 0.38 ± 0.16 cm²; P = 0.0151). While measured cross-sectional areas were marginally lower for HA compared to CaHA at both levels of volume injected, this was not statistically significant (P = 0.0875). Similarly, material type did not affect the relation between measured area and injected volume (P = 0.8805).</p><p><strong>Conclusions: </strong>Ultrasound measurements may be feasible in assessing the injectate amount in vocal folds injection augmentation. This may be useful in situations where residual injectate amount in the vocal folds is important for clinical decisions, such as timing of thyroplasty after IL. Further clinical studies may elucidate the utility of ultrasound measurements of vocal fold injectate in relation to voice outcomes and stroboscopic findings.</p><p><strong>Level of evidence: 5: </strong></p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304194","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":"Has Research Failed to Identify Risk Factors for Voice Disorders? A Systematic Review of Evidence in Teachers.","authors":"Jonas Hauck, Sarah Lang, Franca Schultheis, Christian Gegner","doi":"10.1016/j.jvoice.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.023","url":null,"abstract":"<p><strong>Objectives: </strong>Dysphonia poses a major occupational risk for teachers. Despite the growing interest in this area of research, there is still no comprehensive understanding of the risk factors.</p><p><strong>Methods: </strong>This systematic review examined risk factors for voice disorders among K-12 teachers. It analyzed 111 publications from 33 countries that were published between January 2013 and February 2024. The novel SIMU Matrix was used to categorize the factors as social/individual or modifiable/unmodifiable.</p><p><strong>Results: </strong>Based on the proportion of studies that reported significant associations, 10 factors demonstrated the strongest association with voice disorders. Unmodifiable social factors included elementary teaching (14/29 studies). Unmodifiable individual factors included gender (21/40 studies), age (12/41 studies), and professional experience (12/34 studies). Notably, a paradox regarding gender emerged: women reported more voice problems through self-assessments yet demonstrated better vocal health through laryngological and acoustic examinations. Modifiable social factors included workload (13/31 studies) and noise exposure (14/21 studies). Modifiable individual factors included ENT symptoms (17/23 studies), chronic stress (12/15 studies), loud speaking (11/14 studies), and frequency of sick leave (11/13 studies). Assessment methods varied considerably, with a concerning reliance on single-item measurements, despite the fact that voice disorders are recognized as multidimensional conditions.</p><p><strong>Conclusions: </strong>This review identified numerous factors associated with voice disorders in teachers, demonstrating the complexity of this issue. Some of these factors are modifiable, offering concrete intervention opportunities regarding workplace conditions and health behaviors. However, despite extensive research investigating an even broader range of potential influences, there is still no consensus on key risk factors. This may reflect methodological limitations, including heterogeneous assessments, inadequate statistical corrections, and predominantly cross-sectional designs. Future research requires standardized assessment approaches, appropriate statistical rigor, and longitudinal designs to establish causal relationships and inform evidence-based prevention strategies.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294282","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":"In-Office KTP Laser Surgery for Benign Vocal Fold Lesions in East Asian Patients: Voice Outcomes and Procedural Tolerance.","authors":"Ji-Hoon Kim","doi":"10.1016/j.jvoice.2025.09.034","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.034","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>To determine whether in-office potassium-titanyl-phosphate (KTP) laser surgery provides significant voice improvement and acceptable tolerance in East Asian patients with benign vocal-fold lesions.</p><p><strong>Study design: </strong>Retrospective single-center cohort (Level IV).</p><p><strong>Methods: </strong>Eighty-two consecutive adults (mean ± SD = 43.7 ± 13.7 years) underwent in-office KTP laser surgery under topical anesthesia between March 2024 and February 2025. Preoperative/postoperative assessments included the Voice Handicap Index (VHI), jitter, shimmer, soft-phonation index (SPI), noise-to-harmonics ratio (NHR), and videostroboscopy (glottic closure, mucosal wave, each graded on a 0-3 ordinal scale) by a single board-certified otolaryngologist, and tolerance metrics-nasal pain, throat pain, and gag-reflex intensity measured on a 0-10 visual analogue scale (VAS), and willingness-to-repeat/-recommend measured on a 0-10 numeric rating scale (NRS). Wilcoxon signed-rank tests and Spearman correlations were applied.</p><p><strong>Results: </strong>VHI improved by -33 points (95% CI -40.6 to -25.4; P < 0.001). Jitter, shimmer, and SPI fell by 36%, 41%, and 29%, respectively (P ≤ 0.004); NHR showed no significant change. Videostroboscopy confirmed better glottic closure (+1.33) and mucosal wave (+0.47; P < 0.001). Mean nasal pain 2.95 ± 1.50, throat pain 2.14 ± 1.67, and gag reflex 2.67 ± 1.80 were modest; willingness-to-repeat and-recommend were 8.16 ± 2.27 and 7.26 ± 1.76. Nasal pain (ρ = -0.50) and gag reflex (ρ = -0.75) inversely correlated with willingness scores (P < 0.001); discomfort did not correlate with voice gains.</p><p><strong>Conclusion: </strong>In-office KTP laser surgery yields robust, clinically meaningful voice improvement in East Asian patients while maintaining good patient acceptance. Optimizing topical anesthesia-particularly for patients with narrow nasal passages or septal spurs-may further enhance tolerance without compromising efficacy.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294223","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":"A Novel Machine Learning-Driven Voice and Clinical Biomarkers Framework for Robust Prediction of Type 2 Diabetes Mellitus.","authors":"Jingjing Guo, Weiqun Peng, Shuping Hu, Donghui Lu, Shuo Chen","doi":"10.1016/j.jvoice.2025.09.033","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.033","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a multimodal, machine learning-based framework that integrates acoustic voice features with baseline clinical parameters for noninvasive and accurate screening of type 2 diabetes mellitus (T2DM).</p><p><strong>Materials and methods: </strong>We analyzed data from 3129 individuals, including 1158 with T2DM and 1971 without. Voice recordings were collected under standardized conditions and processed with the openSMILE toolkit to extract 88 acoustic features, encompassing prosodic, spectral, cepstral, and quality-related parameters. In parallel, 30 clinical features were obtained from demographic, anthropometric, biochemical, lifestyle, and medical history variables. After preprocessing and imputation, feature selection was conducted using LASSO, ANOVA, Mutual Information, and Recursive Feature Elimination. Dimensionality reduction with Principal Component Analysis was also evaluated. Models, including Logistic Regression, Random Forest, XGBoost, TabNet, and TabTransformer, were trained with cross-validation and tuned through grid and randomized searches. Performance was assessed on an independent test set using accuracy, recall, and area under the curve (AUC). Model interpretability was addressed via SHAP analysis, t-SNE visualization, and radar plots. Clinical utility was assessed with nomogram construction, calibration, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Models using clinical features alone achieved moderate performance (AUC ≈ 69%). Acoustic-only models performed better, with the LASSO + XGBoost combination reaching an AUC of 80.8%. The fused feature set markedly outperformed both unimodal approaches, with the LASSO + XGBoost model achieving 94.1% accuracy, 93.6% recall, and an AUC of 95.2%. SHAP analysis identified HbA1c, fasting glucose, HOMA-IR, and acoustic markers such as jitter and shimmer as top predictors. Calibration plots showed excellent agreement between predicted and observed probabilities, while DCA demonstrated superior net clinical benefit.</p><p><strong>Conclusions: </strong>Our multimodal framework provides an accurate, interpretable, and clinically actionable approach for noninvasive T2DM screening. Future studies should validate these findings in diverse populations and explore integration into real-world digital health platforms.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294261","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 Relationship Between Vocal Tract Discomfort Symptoms Reporting With Personality Traits and Psychological Distress.","authors":"Saeed Saeedi, Mehdi Soleimani, Mahshid Aghajanzadeh, Payman Dabirmoghaddam","doi":"10.1016/j.jvoice.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.020","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>This study aimed to investigate the relationship between the Vocal Tract Discomfort Scale-Persian (VTDS-P) and personality traits, as well as psychological distress, and to identify VTDS-P score thresholds corresponding to different personality traits and levels of psychological distress.</p><p><strong>Methods: </strong>A sample consisting of 55 voice-disordered (mean age: 42.84 ± 12.02 years) patients and 64 normophonic controls (mean age = 37.06 ± 11.05 years) was considered. The participants completed (a) the VTDS-P, (b) the NEO Five-Factor Inventory (NEO-FFI), and (c) the Depression Anxiety and Stress Scale-21 (DASS-21).</p><p><strong>Results: </strong>Significant medium to large correlations existed between anxiety state and the frequency, severity, and total score of VTDS-P (r = 0.185 to 0.513, P < 0.05). The cut-off scores to distinguish the voice-disordered patients and normophonic controls for the frequency, severity, and total score of VTDS-P were established at 9.50, 7.50, and 19.50, respectively. Total VTDS-P scores of 20, 44, and 57 were found to correspond to mild, moderate, and severe anxiety state levels of DASS-21, respectively.</p><p><strong>Conclusions: </strong>As VTDS-P scores increased beyond the cut-off, there was a pattern of anxiety state increasing, ranging from moderate to severe. Given the bidirectional relationship between vocal tract discomfort and anxiety state levels, it is essential that anxiety state in voice-disordered patients be screened and referred to mental health specialists if necessary. Conversely, individuals with an anxiety state seeking help in mental health clinics should also be screened for potential vocal tract discomfort and referred to a voice team for further assessment if necessary.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294254","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":"Complications of Various Materials for Injection Laryngoplasty: Systematic Review and Meta-Analysis.","authors":"Anuja H Shah, Erin E Briggs, Shaun A Nguyen, Justin C Pelic, Johnathan M Brown, Ashli K O'Rourke, Kirsten D Meenan","doi":"10.1016/j.jvoice.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.016","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this review is to investigate the complications of various common materials for injection laryngoplasty (IL): autologous fat (AF), calcium hydroxylapatite (CaHA), hyaluronic acid (HA), and carboxymethylcellulose (CMC).</p><p><strong>Methods: </strong>The literature was queried for articles reporting complications in patients undergoing IL with AF, CaHA, HA, or CMC. Outcome measures include proportions (%) with 95% confidence intervals (CI) of procedural complications (inflammation, granuloma, hematoma, delayed cyst, misplaced/superficial injection, extrusion/migration, and inadvertent overinjection), airway compromise (stridor, dyspnea), and postinjection intervention (steroid treatment, intubation, and tracheotomy). A comparison of proportions, expressed as difference (Δ) and 95% CI, was completed between materials.</p><p><strong>Results: </strong>Of 551 abstracts identified, 58 studies (N = 2868 patients) were included. Procedural complications following CaHA-IL (11.03% [CI: 4.7-19.5]) occurred at a significantly higher rate than AF-IL (Δ5.97 [CI: 3.1-8.6], P = 0.0001), HA-IL (Δ5.60 [CI: 3.2-8.0], P < 0.0001), and CMC-IL (Δ7.68 [CI: 1.3-10.7], P = 0.024). The highest incidence of airway compromise occurred in HA-IL (3.73% [CI: 1.6-6.6]), followed by AF-IL (1.85% [CI: 0.86-3.5]) and CaHA-IL (0.69% [CI: 0.23-1.6]). Airway compromise was significantly higher following HA-IL compared with CaHA-IL (Δ3.05 [CI: 1.6-4.6], P < 0.0001). There was no significant difference in airway compromise between AF-IL and CaHA-IL (Δ1.17 [CI: -0.07-2.0], P = 0.058) or AF-IL and HA-IL (Δ1.88 [CI: -0.08-3.6], P = 0.055). There was no significant difference in frequency of postinjection intervention in patients undergoing AF-IL (3.53% [CI: 1.8-6.2]) and HA-IL (2.52% [CI: 1.6-3.8]) (Δ1.01 [CI: -1.0-3.9], P = 0.360).</p><p><strong>Conclusions: </strong>IL is generally safe with the commonly used materials (AF, CaHA, HA, and CMC), with a low overall complication rate across materials. CaHA demonstrates a higher rate of procedural complications, while HA carries a mildly higher risk for airway compromise. Clinicians should select injection material based on patient factors with an awareness for the likelihood of risks based on material.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294245","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":"Prevalence and Risk Factors of VDs Among Henan Opera Performers in Henan Province: A Cross-Sectional Study.","authors":"Yanhua Shang, Xiangsheng Mei, Bingwei Ai","doi":"10.1016/j.jvoice.2025.09.031","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.09.031","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the prevalence of voice disorders (VDs) and associated risk factors among Henan Opera performers in Henan Province.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 104 Henan Opera performers in Henan Province using an online survey. VDs were defined as experiencing one or more voice symptoms (such as hoarseness, vocal fatigue, etc) in the past three months. Structured questionnaires were used to collect data on demographic characteristics, professional voice use characteristics, and vocal health status. Chi-square tests and Firth logistic regression (to address complete separation in small sample analysis) were performed for statistical assessment.</p><p><strong>Results: </strong>The prevalence of VDs among Henan Opera performers in Henan Province was 77.9%. Multivariate analysis indicated that employment in private troupes (OR = 8.08, 95% CI: 2.54-33.79), smoking (OR = 11.83, 95% CI: 1.35-1560.34), and unhealthy dietary habits (OR = 3.26, 95% CI: 1.15-9.70) were independent risk factors. VDs caused significant occupational and medical burden: the medical consultation rate (89.5%), performance interruption rate (88.2%), and income loss rate (98.1%) among performers with VDs were all significantly higher than those without VDs (P < 0.05).</p><p><strong>Conclusion: </strong>The study demonstrates a high prevalence of VDs among Henan Opera performers in Henan Province, with significant associations identified for private troupe affiliation, smoking, and unhealthy dietary habits. Immediate interventions should include smoking cessation programs and dietary guidance for Henan Opera performers, and specialized vocal training for private troupe performers. Further longitudinal research is necessary to establish causal relationships and to assess the effectiveness of these interventions.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259762","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}