Journal of Voice最新文献

{"title":"Botulinum Toxin-Based Study: Histological Changes in the Rabbit Vocal Folds and Construction of the Voice Rest Model With Different Rest Durations.","authors":"Linlin Lan, Peiyun Zhuang","doi":"10.1016/j.jvoice.2024.12.045","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.12.045","url":null,"abstract":"<p><p>There is currently no unified standard for optimal voice rest following vocal fold surgery, and inconsistencies in related clinical trials highlight the necessity of basic scientific research. However, existing animal models for voice rest have significant limitations, and no systematic establishment of a series of animal models with varying durations of voice rest that align with clinical trends has been achieved. This study was designed in two parts. In the first part, 1 U of botulinum toxin type A was injected into the unilateral thyroarytenoid muscle of rabbits, using hematoxylin-eosin staining to assess structural changes in the vocal folds and the gray-level co-occurrence matrix method to analyze texture features, thus ruling out potential effects of botulinum toxin on vocal fold structure. In the second part, 0.025 U, 0.0625 U, 0.175 U, and 0.375 U of botulinum toxin were injected into the unilateral thyroarytenoid muscle of rabbits, and at continuous, specific time points, Kinovea 0.9.5 software was used to track and analyze changes in left-right vocal fold movement over time in laryngoscopic videos, as well as the movement ratio, to evaluate the reliability of using low-dose botulinum toxin injections to simulate an animal model of voice rest. The results showed that 1 U botulinum toxin had no effect on vocal fold structure, and doses of 0.025 U, 0.0625 U, 0.175 U, and 0.375 U corresponded to voice rest durations of 1, 3, 7, and 14 days, respectively. In conclusion, injecting different doses of botulinum toxin into the unilateral thyroarytenoid muscle can induce transient immobility of the unilateral vocal fold, establishing rabbit models for varying durations of voice rest. This study proposes an innovative method to develop voice rest models of different durations by applying low-dose botulinum toxin to the neuromuscular junction of the vocal fold, potentially aiding in research to determine optimal voice rest durations for vocal fold wound healing.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781372","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":"Comparative Analysis of Preoperative and Postoperative Voice Parameters in 93 Cases of Vocal Fold Cyst.","authors":"Toshiyuki Mitsuhashi, Hirohito Umeno, Shun-Ichi Chitose, Takashi Kurita, Kyoji Furukawa, Fumihiko Sato, Kiminobu Sato, Mioko Fukahori, Takeharu Ono, Shintaro Sueyoshi, Sachiyo Hamakawa","doi":"10.1016/j.jvoice.2025.03.026","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.026","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>We investigated the characteristics of vocal fold cysts (VFCs) by assessing preoperative impairments and postoperative improvements across multiple voice parameters.</p><p><strong>Methods: </strong>Data from 93 VFCs treated with microflap surgery at Kurume University Hospital (1996-2022) were retrospectively reviewed. Cyst size was calculated as the ratio of the cyst diameter to the distance from the anterior commissure to the vocal process. VFCs were histologically classified into retention, epidermoid, and unclassified (due to insufficient tissue) types. They were also classified as subepithelial cysts (VFC-SE) and ligamentous cysts (VFC-lig) based on depth. Postoperative differences (Δ) were calculated for voice parameters, including the maximum phonation time, mean flow rate, fundamental frequency (F₀), F₀ range in semitones, sound pressure level (SPL), SPL range, pitch perturbation quotient, amplitude perturbation quotient (APQ), jitter, shimmer, normalized noise energy, noise-to-harmonic ratio, and Voice Handicap Index-10 scores.</p><p><strong>Results: </strong>Patients with epidermoid cysts were significantly younger than those with retention cysts (P = 0.01). All parameters except the SPL range (in men) significantly improved postoperatively, whereas F₀ changes were statistically insignificant. Cyst size positively correlated with preoperative APQ (Spearman's ρ = 0.343, P = 0.02) and shimmer (ρ = 0.334, P = 0.03) and negatively correlated with ΔAPQ (ρ = -0.301, P = 0.04) and Δshimmer (ρ = -0.303, P = 0.04). Compared with VFC-lig, VFC-SE showed greater preoperative shimmer (P = 0.01) and a lesser postoperative F₀ range (P = 0.0495). The preoperative values and postoperative differences were not significantly different among the histological cyst types.</p><p><strong>Conclusions: </strong>The age difference between patients with epidermoid and retention cysts may reflect distinct cyst etiologies. Large cysts significantly disrupted preoperative mucosal wave dynamics, particularly affecting amplitude irregularities, with greater potential for postoperative improvement. Microflap surgery effectively improved voice parameters in patients with VFCs, regardless of classification by histology or depth.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774646","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":"Reliability and Severity Levels of the Voice-Related Experiences of Nonbinary Individuals.","authors":"Grace Shefcik, Pei-Tzu Tsai, Satveer Kler","doi":"10.1016/j.jvoice.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.009","url":null,"abstract":"<p><strong>Objectives: </strong>Clinicians providing gender-affirming communication services to nonbinary individuals often utilize client questionnaires. The Voice-related Experiences of Nonbinary Individuals (VENI) is the only published questionnaire exclusively for nonbinary clients. This questionnaire consists of 17 items that gain insight into the client's self-perception of voice and voice-related concerns. According to Shefcik and Tsai (2023), the VENI's content validity is good to excellent. This study evaluated the measure's reliability through internal consistency and test-retest reliability analyses and created impact ratings to support interpretation of scores.</p><p><strong>Study design: </strong>This study utilized an online survey-based design with test-retest administration. The initial survey was administered to evaluate internal consistency and create severity scores. The retest survey was administered 3-5 weeks after the initial survey to evaluate test-retest reliability.</p><p><strong>Methods: </strong>Fifty-five nonbinary participants with a desire to modify their voice and who were not receiving gender-affirming communication services completed the first survey. Respondents completed the VENI and self-reported the degree that their voice adversely impacts their daily life. Internal Consistency Coefficient (ICC) and item total correlations (ITC) were used to evaluate internal consistency. Thirty participants from the initial survey retook the VENI after 3-5 weeks. Intraclass correlation coefficient (ICCC), Pearson's r, and standard error of measurement (SEM) were used to evaluate test-retest reliability.</p><p><strong>Results: </strong>ICC was α = 0.85 and ITCs ranged between r = 0.11 and 0.72. Severity scores were created through standard deviations from the mean, resulting in five classifications from \"mild\" to \"severe.\" Comparison of VENI scores between test and retest resulted in Pearson's r = 0.89, P =< 0.001, SEM = 3.03, and the ICCC for the measure was 0.88.</p><p><strong>Conclusion: </strong>The VENI has good internal consistency and strong test-retest reliability. Clients' VENI scores can be interpreted using the SEM and impact rating classifications derived from the sample analyzed in this study. This improves clinicians' ability to evaluate and monitor clients' scores. This study supports the use of the VENI as a reliable tool for high-quality, individualized interventions in clinical and research purposes.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765623","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":"Laryngeal Symptoms in Anti-IgLON5 Disease: Case Reports and a Systematic Review of Airway Management and Recommendations.","authors":"D Alayadhi, T Mouton, N Voisin, B Coulombeau, A R Pérouse, P Céruse, P Philouze","doi":"10.1016/j.jvoice.2025.03.023","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.023","url":null,"abstract":"<p><p>Anti-IgLON5 disease, a rare neuroimmunological disorder, frequently manifests with aerodigestive symptoms such as dysphagia, dysarthria, acute respiratory failure, and eventually death. The Anti-IgLON5 disease is under-recongnized in the field of otolaryngology. Therefore, the aim of this systematic review is to summarize the current literature on airway management in Anti-IgLON5 disease, a potentially life-threatening condition, and present two cases that highlight the critical importance of early recognition and intervention for laryngeal symptoms. A comprehensive search of PubMed/MEDLINE for studies related to Anti-IgLON5 and respiratory complications was conducted, focusing on articles published before September 13, 2024. Cases involving airway presentation and management were included. The literature review included 16 articles yielded 28 patients, revealing that 78.5% required tracheotomy due to respiratory failure or laryngeal symptoms. Dysphagia and obstructive sleep apnea were the most common presenting symptoms of the disease. Bilateral vocal cord (VC) paralysis was observed in 67% of cases, though it often developed later in the disease course. The two case reports align with these findings, illustrating that early tracheotomy may be necessary to prevent sudden death, even in patients with initial VC mobility. Anti-IgLON5 disease can lead to severe airway compromise, necessitating early intervention. Regular otolaryngological evaluation and polysomnography are critical in managing these patients, and tracheotomy should be considered a key preventive measure against respiratory failure. Awareness of IgLON5 antibodies as a differential diagnosis in patients presenting with unexplained laryngeal symptoms is essential for timely intervention.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765603","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":"Development and Rationale for the Consensus Auditory-Perceptual Evaluation of Voice-Revised (CAPE-Vr).","authors":"Gail B Kempster, Kathleen F Nagle, Nancy Pearl Solomon","doi":"10.1016/j.jvoice.2025.01.022","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.01.022","url":null,"abstract":"<p><strong>Rationale: </strong>The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) has been in circulation for more than 20 years. Over the course of time, issues have arisen that have had an impact on the intended administration and interpretation of this common clinical tool.</p><p><strong>Purpose: </strong>Based on published literature, clinical experience, recent survey data, and practical considerations, and while maintaining the original purpose of the instrument, the authors developed a revised protocol, new rating form, and updated instructions for the CAPE-V, now called the CAPE-V-Revised (CAPE-Vr).</p><p><strong>Summary of modifications: </strong>Revisions to the CAPE-V include the following: removal of textual labels indicating regions of severity under each visual analog scale on the rating form, instead displaying terms indicating the direction of the lines; modification of several of the stimuli; revised rating options for pitch, loudness, and resonance, and an added category for nasality; added space to describe inconsistencies according to task; modified options for vocal instabilities and other features; and added space for comments about overall impression. The form also includes sections for documenting recording and rating conditions. Updated instructions are provided to clarify the CAPE-Vr protocol and correspond closely to the rating form.</p><p><strong>Conclusion: </strong>The CAPE-Vr is constructed to avoid common errors and problems identified from previous use of the original CAPE-V. This paper provides a rationale for each modification to the original CAPE-V, an updated form, and an example of a completed form. The CAPE-Vr is intended as a clear and useful assessment tool for documenting the auditory-perceptual evaluation of voice.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765601","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":"Neuromodulation for Laryngeal Dystonia: A Systematic Review.","authors":"Chang Woo Lee, Marie T Krüger, Harith Akram, Ludvic Zrinzo, Wanding Yang, Nick Hamilton, John S Rubin, Martin A Birchall, Jonathan M Fishman","doi":"10.1016/j.jvoice.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.017","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to systematically review and evaluate neuromodulation therapies that are currently being explored/used in the treatment of laryngeal dystonia (LD).</p><p><strong>Methods: </strong>A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines searching Embase, Medline, and Cochrane with the cover period January 1960-August 2024. The search strategy used was ((\"Laryngeal Dystonia\" OR \"Spasmodic Dysphonia\") AND (\"Neuromodulation\" OR \"Deep Brain Stimulation\")). Articles were reviewed and screened based on the set inclusion and exclusion criteria. The Joanna Briggs Institute Critical Appraisal Checklists were used to assess the risk of bias in the included studies. Patient demographics and diagnosis, neuromodulation therapy used and its details, voice outcomes, and complications were extracted from each of the studies. A narrative review was subsequently synthesized.</p><p><strong>Results: </strong>Twelve studies met the selection criteria and were included. In total, 130 LD patients were identified with the following neuromodulation therapies being evaluated for their use in LD: vibro-tactile stimulation, laryngeal electrical stimulation, pharmacologic (sodium oxybate), repetitive transcranial magnetic stimulation, and deep brain stimulation (DBS). All included studies reported various degrees of improvement in patients' voice symptoms with the neuromodulation therapy used. No definitive conclusion could be drawn for their efficacy within the included studies consisting of six case reports, three proof-of-concept/pilot studies, and three phase I clinical trials that used a number of different voice outcome measures used to report treatment effects, and a general lack of long-term follow-up. No significant complications were reported for any of the neuromodulation therapies.</p><p><strong>Conclusion: </strong>Most neuromodulation therapies being explored for LD are at a very early exploratory stage. Although more clinical trials are required, from the available evidence, sodium oxybate and DBS currently appear to have the most potential for translation into clinical practice.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755132","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":"Linguistic Adaptation and Validation of the Algerian Arabic Dialect Voice Handicap Index for Parkinson's Disease Patients.","authors":"Ali Kaddour, Kamel Ferrat, Ouarda Metref, Yasser Mechri","doi":"10.1016/j.jvoice.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.018","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to validate a transcribed version of the Arabic Voice Handicap Index (VHI) into the Arabic Algerian dialect for Parkinson's disease (PD) patients.</p><p><strong>Study design: </strong>A cross-sectional survey study was carried out.</p><p><strong>Methods: </strong>The Arabic VHI was translated, linguistically adapted, and transcribed into the Algerian Arabic dialect using a hybrid phonetic transcription. The transcribed VHI was then administered to 44 patients with voice disorders related to idiopathic PD, and 45 control participants. All individuals with PD underwent a perceptual auditory assessment using GRBAS scale, to compare results with self-assessments using the transcribed VHI.</p><p><strong>Results: </strong>The transcribed Algerian Arabic VHI demonstrated high internal consistency and reliability (Cronbach's α = 0.93; test-retest reliability r = 0.79), with strong item-domain and domain-total correlations (r = 0.74-0.79; P < 0.05). A statistically significant difference was observed between the control group and the voice-disordered group (P < 0.001). The transcribed VHI showed a strong correlation with the GRBAS scale auditory-perceptual assessment (r = 0.78; P < 0.05).</p><p><strong>Conclusion: </strong>The Algerian Arabic VHI exhibits strong psychometric properties, confirming its validity and reliability as a self-assessment tool to evaluate voice disorders in Algerian Arabic dialect-speaking PD patients.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755128","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":"Clinical Relevance and Therapeutic Findings of Chronic Cough Related to Laryngopharyngeal Reflux Disease.","authors":"Jérôme R Lechien","doi":"10.1016/j.jvoice.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.011","url":null,"abstract":"<p><strong>Objective: </strong>To investigate clinical significance of chronic cough in patients with laryngopharyngeal reflux disease (LPRD) and evaluate the potential of cough as a predictor for clinical findings and treatment outcomes.</p><p><strong>Methods: </strong>Data of patients with a positive diagnosis of LPRD at the 24-hour hypopharyngeal-esophageal multi-channel intraluminal impedance-pH monitoring (HEMII-pH) prospectively followed at the European Reflux Clinic and Elsan Hospital from January 2017 to August 2024 were retrieved. Four study groups were established based on chronic cough severity. Between-group analysis included HEMII-pH parameters (number and pH of pharyngeal reflux events), pretreatment and post treatment reflux symptom scores (RSS), reflux sign assessment (RSA), and gastrointestinal endoscopy findings.</p><p><strong>Results: </strong>The study included 523 patients [303 females (57.9%) and 220 males (42.1%)]. Of the 523 patients with LPRD, 326 (62.3%) had mild-to-severe chronic cough. The mean ages of patients ranged from 50.3 to 52.7 years. The cough severity score was associated with the severity of otolaryngological, digestive, and non-cough respiratory symptoms, with the mildest presentations in patients without chronic cough. The magnitude of pretreatment to post treatment changes in RSS and RSA decreased as cough severity increased. Patients with chronic cough demonstrated higher post therapeutic otolaryngological and non-cough respiratory symptom scores, while there were no significant differences across groups for digestive symptoms. The therapeutic response rate was 75.1%, without demonstrating significant differences between patients with chronic cough (75.9%) and those without (73.8%). The cough severity score was a predictor of the post treatment RSS (r_s = 0.222; P = 0.001).</p><p><strong>Conclusion: </strong>Chronic cough is a predominant symptom in LPRD with a prevalence of 62.3%. At baseline presentation, chronic cough severity is suggestive of a significant prognostic indicator of LPRD RSS severity.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755118","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":"Development of a Machine Learning Model to Predict Therapeutic Responses in Laryngopharyngeal Reflux Disease.","authors":"Su Il Kim, Young-Gyu Eun, Young Chan Lee","doi":"10.1016/j.jvoice.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.015","url":null,"abstract":"<p><strong>Objectives: </strong>Laryngopharyngeal reflux disease (LPRD) is a challenging condition requiring effective treatment. Thus, understanding the factors that influence therapeutic response in LPRD is crucial. This study leverages machine learning models to predict the therapeutic responses and identify the key influencing factors in LPRD.</p><p><strong>Methods: </strong>Patients with typical LPRD symptoms showing more than one pharyngeal reflux episode on 24-hour multichannel intraluminal impedance (MII)-pH monitoring were collected retrospectively from two independent otolaryngologic clinics. Patients who were prescribed proton pump inhibitor therapy and followed up for at least 2 months were included. Patients who showed a ≥50% decrease in the follow-up reflux symptom index score during treatment periods compared with pre treatment were defined as responders. Among various demographic and 24-hour MII-pH monitoring parameters, features showing the absolute correlation coefficients ≥0.1 with response were selected. Four machine learning models-logistic regression, random forest, support vector machine, and gradient boosting-were applied to the training cohort and assessed in the internal and external validation cohorts.</p><p><strong>Results: </strong>Patients from two otolaryngologic clinics were assigned to the internal dataset (n = 157) and external dataset (n = 53). All four models showed comparable predictive performances, illustrating their potential utility in clinical decision-making. Among them, the logistic regression model demonstrated the best performance with accuracy and F1 scores of 82.98% and 88.24% in the internal validation cohort and 84.91% and 86.21% in the external validation cohort predicting therapeutic responses in LPRD. Feature importance analysis revealed vital factors, such as proximal total reflux time and weak acid time, influencing therapeutic response, and offering insights into LPRD management.</p><p><strong>Conclusions: </strong>This study provides valuable insights into the factors influencing the therapeutic response in LPRD, underscoring the utility of machine learning in refining treatment strategies. Our findings suggest that integrating machine learning models into clinical practice can significantly improve LPRD management.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755125","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":"Vocal Resonance Alterations Following Anterior Palatoplasty and Expansion Sphincter Pharyngoplasty.","authors":"Şaban Eyisaraç, Halil Erdem Özel, Adin Selçuk, Ferit Bayakır, Serdar Başer, Erdem Altıparmak, Selahattin Genç, Fatih Özdoğan, Erdem Köroğlu","doi":"10.1016/j.jvoice.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.010","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to examine the effects of combined anterior palatoplasty (AP) and expansion sphincter pharyngoplasty (ESP) on vocal resonance and nasalization in patients with mild to moderate obstructive sleep apnea syndrome (OSAS), utilizing objective testing methods.</p><p><strong>Materials and methods: </strong>A total of 28 patients with mild to moderate OSAS, determined by polysomnography, were included in the study. Preoperative assessments and postoperative evaluations at the 1st and 6th months were conducted, during which patients produced steady sustained phonation of the vowels /ɑ/, /ɛ/, /ɯ/, /i/, /ɔ/, /œ/, /u/, and /y/. Formant frequencies (F0, F1, F2, F3, and F4) were analyzed. Additionally, nasalization was evaluated using the vowel /ɑ/ in the syllable /ɟ ɑ ɟ/ and quantified by analyzing F0, F1, F2, F3, F4, and A1P0 values, where A1 represents the amplitude of the first formant harmonic peak and P0 represents the amplitude of the lowest nasal peak.</p><p><strong>Results: </strong>No statistically significant changes were observed in the fundamental frequency (F0) of any vowels before and after surgery. At 6 months postoperatively, significant decreases in F1 for /ɑ/ (P = 0.047) and F3 for /u/ (P = 0.017) were noted. Nasalization measurements at 6 months showed significant changes, including a decrease in F3 (P = 0.023), an increase in F4 (P = 0.025), and a decrease in A1P0 values for nasalized /ɑ/ (P = 0.013).</p><p><strong>Conclusion: </strong>AP + ESP affect vocal resonance specifically in back vowels (/ɑ/, /u/), and leads to nasalization, consistent with the surgical focus on the velopharyngeal region, while preserving fundamental frequency across all vowels. These alterations might influence how individuals perceive their voice, possibly having particular relevance for professional voice users.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755135","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}