Journal of Voice最新文献

{"title":"Auditory-perceptual Parameters as Predictors of Voice Acoustic Measures","authors":"Duy Duong Nguyen,&nbsp;Catherine Madill","doi":"10.1016/j.jvoice.2023.02.030","DOIUrl":"10.1016/j.jvoice.2023.02.030","url":null,"abstract":"<div><h3>Background</h3><div>Much research has examined the relationship between perceptual and acoustic measures. However, little is known about the prediction values of perceptual measures on an acoustic parameter.</div></div><div><h3>Aims</h3><div>This study utilized simulated and disordered voice samples to investigate the prediction values of breathiness, roughness, and strain ratings on the selection of some time-based and spectral-based measures of voice quality.</div></div><div><h3>Method</h3><div>This study retrospectively analysed two sets of precollected data. The experimental data had been collected from nine trained speakers manipulating false vocal fold activity, true vocal fold mass, and larynx height. The voice-disordered data had been extracted from a clinical database for 68 patients with muscle tension voice disorders (MTVD). Both data sets had been perceptually rated for breathiness, roughness, and strain. Voice samples (prolonged vowel /ɑ/ and Rainbow Passage readings) had undergone acoustic analysis using Praat for harmonics-to-noise ratio (HNR) and the program “Analysis of Dysphonia in Speech and Voice” (ADSV) for cepstral peak prominence (CPP), Cepstral/Spectral Index of Dysphonia (CSID), and Low/High spectral ratio (L/H ratio). Perceptual parameters were regressed against these acoustic measures to test their prediction values.</div></div><div><h3>Results</h3><div>Reliability data showed satisfactory intra- and inter-reliability of perceptual ratings for both data sets. Breathiness significantly predicted CPP (both vocal tasks) and CSID (Rainbow Passage) in experimental data and predicted all the acoustic measures in MTVD data. Roughness significantly predicted HNR, CPP, and CSID in experimental data, and CPP (Rainbow Passage) and CSID (both vocal tasks) in MTVD data. Strain (both vocal tasks) significantly predicted L/H ratio in both data sets.</div></div><div><h3>Conclusions</h3><div>Breathiness ratings predicted selection of HNR, CPP and CSID; roughness ratings predicted selection of CPP and CSID, and strain ratings predicted L/H ratio.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1225-1235"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9227888","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":"Visual Interpretation of Vocal Fold Paralysis in Flexible Laryngoscopy Using Eye Tracking Technology","authors":"Katherine P. Wallerius,&nbsp;Semirra L. Bayan,&nbsp;Michael F. Armstrong,&nbsp;Chiamaka A. Lebechi,&nbsp;Jacob K. Dey,&nbsp;Diana M. Orbelo","doi":"10.1016/j.jvoice.2023.02.035","DOIUrl":"10.1016/j.jvoice.2023.02.035","url":null,"abstract":"<div><h3>Objectives</h3><div><span>Interpretation of laryngoscopy is an important diagnostic skill in </span>otolaryngology<span>. There is, however, limited understanding of the specific visual strategies used while assessing flexible laryngoscopy video. Eye-tracking technology allows for objective study of eye movements during dynamic tasks. The purpose of the present study was to explore visual gaze strategies during laryngoscopy interpretation of unilateral vocal fold paralysis (UVFP) across clinician experience from novice to expert.</span></div></div><div><h3>Methods</h3><div>Thirty individuals were shown five flexible laryngoscopy videos, each 10 seconds long. After viewing each video, participants reported their impressions of “left vocal fold paralysis,” “right vocal fold paralysis,” or “no vocal fold paralysis.” Eye tracking data were collected and analyzed for duration of fixation and number of fixations on select areas of interest (AOI). Diagnostic accuracy and visual gaze patterns were compared between novice, experienced, and expert groups.</div></div><div><h3>Results</h3><div>Diagnostic accuracy among learners in the novice group was significantly lower than those in the more experienced groups (<em>P</em> = 0.04). All groups demonstrated similar visual gaze patterns when viewing the video with normal bilateral vocal fold mobility, spending the greatest percentage of time viewing the trachea. There were differences among groups when viewing the videos of left or right VFP, but the trachea was always in the top three structures for greatest fixation duration and highest number of fixations.</div></div><div><h3>Conclusions</h3><div>Eye-tracking is a novel tool in the setting of laryngoscopy interpretation. With further study it has the potential to be useful for the training of otolaryngology learners to improve diagnostic skills.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1339-1345"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235187","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":"Thyroarytenoid Muscle Avulsion","authors":"Philip J. Maxwell ,&nbsp;Daniel Eichorn ,&nbsp;Robert T. Sataloff","doi":"10.1016/j.jvoice.2023.03.008","DOIUrl":"10.1016/j.jvoice.2023.03.008","url":null,"abstract":"<div><div><span><span><span>Thyroarytenoid muscle avulsion is a rare condition in which laryngeal trauma<span> causes a separation of the thyroarytenoid muscle from the arytenoid cartilage. Typically, symptoms are nonspecific but include severe </span></span>dysphonia and voice fatigue. They are similar to symptoms of vocal process avulsion. Strobovideolaryngoscopy, laryngeal </span>electromyography, and laryngeal </span>computed tomography<span> may be helpful in diagnosis. However, intraoperative palpation under general anesthesia is the most definitive way to establish its diagnosis. We present two cases of thyroarytenoid muscle avulsion, a condition that has not been described previously. Surgical techniques for repair are detailed.</span></div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1398-1401"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9248487","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 the Prevalence and Associated Risk Factors for Presbylarynx in the Elderly Laryngology Population","authors":"Philip J. Maxwell ,&nbsp;Parastou Azadeh Ranjbar ,&nbsp;Vibhuti Mishra ,&nbsp;Christopher Yam ,&nbsp;Ghiath Alnouri ,&nbsp;Karen Lyons ,&nbsp;Hassan Paknezhad ,&nbsp;Robert T. Sataloff","doi":"10.1016/j.jvoice.2023.03.006","DOIUrl":"10.1016/j.jvoice.2023.03.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;The primary objective of this study was to assess the prevalence of presbylarynx and its associated features in an elderly population representative of patients seen in a tertiary care laryngology practice. The secondary objective of this study was to compare laryngeal &lt;/span&gt;electromyography (LEMG) findings, coexisting &lt;/span&gt;VF conditions, &lt;/span&gt;medical history&lt;span&gt;, surgical history, medication use, and other parameters between patients with and without presbylarynx.&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Adult voice patients aged 60 years and older who underwent strobovideolaryngoscopy were included in the study. Patients were assigned to one of two groups based on the majority (≥2/3) agreement of three blinded authors’ (GA, KL, and HP) graded examinations of strobovideolaryngoscopy (SVL) videos for findings consistent with presbylarynx (atrophic vocal folds [VFA], vocal fold bowing [VFB], vocal process prominence [VPP] and anterior glottic insufficiency [GI]). Patient demographics, medical history, surgical history, medication use, laboratory results, and SVL videos were compiled. Statistical analysis was performed using SPSS 28.0.0.0 (IBM, Armonk, NY). All tests were performed two-tailed, and a &lt;em&gt;P&lt;/em&gt;-value of less than 0.05 was considered statistically significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;One hundred sixty-four patients (84 female/80 male, mean age of 68.397 ± 4.947 years) were included in this study. The prevalence of presbylarynx was 52.4% (n = 86) in the study population. The mean age of patients in the presbylarynx group was significantly higher than the nonpresbylarynx group. Additionally, there were significantly more males than females in the presbylarynx group. The presbylarynx group also was found to have a higher proportion of ACE inhibitor (ACEi) use. Further, laboratory results revealed a significantly higher proportion of patients with elevated &lt;/span&gt;thyroid stimulating hormone&lt;span&gt; (TSH) levels in the presbylarynx group. Conversely, patients in the nonpresbylarynx group were found to have a significantly higher rate of levothyroxine use. On SVL, patients in the nonpresbylarynx cohort were found to have a significantly higher proportion of benign vocal fold lesions and vocal fold &lt;/span&gt;&lt;/span&gt;paresis. However, LEMG testing revealed no statistically significant differences in &lt;/span&gt;muscle recruitment between groups. Men with presbylarynx were found to have a significantly higher proportion of VFB and VPP compared to women with presbylarynx.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This retrospective study investigated the prevalence and risk factors associated with presbylarynx in patients representative of those treated by laryngologists. Signs consistent with presbylarynx are observable even in the presence of coexisting VF conditions. Older age, elevated TSH, the use of ACEi, and male gender was associated with signs of presbylarynx on","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1328-1338"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9602843","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":"Is Thyrohyoid Space Palpation a Reliable and Useful Clinical Tool Within Diagnostic Protocol for Voice Disorders?","authors":"Kaila J. Harris ,&nbsp;Marie E. Jetté ,&nbsp;Mona Abaza ,&nbsp;Matthew S. Clary ,&nbsp;Daniel S. Fink ,&nbsp;Juliana K. Litts","doi":"10.1016/j.jvoice.2023.03.004","DOIUrl":"10.1016/j.jvoice.2023.03.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Palpation of the extrinsic laryngeal muscles<span> is a common part of examination performed by otolaryngologists and speech-language pathologists<span> on individuals presenting with voice complaints, thought to aid in diagnosis and treatment planning. While research has identified a significant relationship between thyrohyoid tension and hyperfunctional voice disorders, we are not aware of any studies exploring correlations between thyrohyoid posture during palpation and the full spectrum of voice disorders. This study aims to identify whether patterns in thyrohyoid posture at rest and during phonation can be related to stroboscopic findings and voice disorder diagnoses.</span></span></div></div><div><h3>Methods</h3><div>A multidisciplinary team of three laryngologists and three speech-language pathologists participated in data collection during 47 new patient visits for voice complaints. Each patient underwent neck palpation and evaluation of thyrohyoid space at rest and during phonation by two independent raters. Clinicians then used stroboscopy to rate glottal closure and supraglottic activity as part of determining primary diagnosis.</div></div><div><h3>Results</h3><div>Strong inter-rater agreement was found for ratings of thyrohyoid space posture both at rest (κ = 0.93) and during phonation (κ = 0.80). Findings revealed no significant correlations between patterns of thyrohyoid posture and laryngoscopic findings or primary diagnoses.</div></div><div><h3>Conclusions</h3><div>Findings suggest that the presented method of laryngeal palpation is a reliable measure for assessing thyrohyoid posture at rest and during phonation. Lack of significant correlation between palpation ratings and other collected measures suggests that this method of palpation is not a useful tool for predicting laryngoscopic findings or voice diagnoses. Laryngeal palpation may still be useful in predicting extrinsic laryngeal muscle tension and guiding treatment planning; however, further research exploring the validity of laryngeal palpation as a measure of extrinsic laryngeal muscle tension is needed, as well as studies that include patient-reported measures and repeated measurements of thyrohyoid posture over time to explore whether thyrohyoid posture is impacted by other factors.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1246-1253"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9772784","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":"Evidence on Vocal Interventions in Adults: A Scoping Review","authors":"Vanessa Veis Ribeiro ,&nbsp;Weslania Nascimento ,&nbsp;Rebeca Cardoso da Silva ,&nbsp;Flavio Magno Gonçalves ,&nbsp;Rosane Sampaio Santos ,&nbsp;Mara Behlau ,&nbsp;Cristiano Miranda de Araujo ,&nbsp;Karinna Veríssimo Meira Taveira","doi":"10.1016/j.jvoice.2023.03.005","DOIUrl":"10.1016/j.jvoice.2023.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>To map the evidence on vocal intervention in people over 18 years old.</div></div><div><h3>Methods</h3><div>A literature search was conducted using the following electronic databases: Cochrane Library, EMBASE, Latin American and Caribbean Literature on Health Sciences (LILACS), LIVIVO, Pubmed/Medline, Scopus, SpeechBITE, and Web of Science. Gray literature was also used as an information source through searches on Google Scholar, Open Grey, ProQuest Dissertation and Thesis, and the Brazilian digital library of theses and dissertations. Systematic reviews (SR) with a population of individuals over 18 years old were included. The included reviews addressed speech-language pathology interventions in the vocal area with reports of their respective outcome. The methodological quality of the included systematic reviews was analyzed using the AMSTAR II tool. Quantitative analysis was performed by frequency distribution, and qualitative research was analyzed through narrative synthesis.</div></div><div><h3>Results</h3><div>A total of 2,443 references were retrieved, among which 20 studies met the inclusion criteria. The included studies had critically low quality, lacking the use of population, intervention, comparison, and outcome (PICO) components. Among the included SRs, 40% were made in Brazil, 45% were published in the Journal of Voice, and 75% analyzed dysphonic patients. The most frequent intervention was voice therapy (direct therapy associated with indirect therapy approaches). Positive results were observed in most of the outcomes for all studies.</div></div><div><h3>Conclusion</h3><div>Voice therapy was described as inducing positive effects for voice rehabilitation. However, due to the critically low quality of studies, the literature did not enable us to understand the best results for each intervention. Well-designed studies are necessary to clarify the relationship between the intervention goal and how the intervention was evaluated.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1409.e1-1409.e14"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9784703","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":"Auditory-Perceptual Judgment of Vocal Resonance in Carnatic Singers by Different Groups of Listeners","authors":"Revathi Raveendran,&nbsp;Yeshoda Krishna","doi":"10.1016/j.jvoice.2023.05.005","DOIUrl":"10.1016/j.jvoice.2023.05.005","url":null,"abstract":"<div><h3>Aim</h3><div>This study was aimed at evaluating the auditory perceptual judgments of vocal resonance by professional singers, speech-language pathologists (SLP) with singing training, and SLPs without singing training.</div></div><div><h3>Objectives</h3><div>(a) To examine the auditory-perceptual judgments of the phonation samples of professional singers obtained before and after resonant voice therapy (RVT) by professional singers, SLPs with singing training, and SLPs without singing training. (b) To compare the agreement between the auditory-perceptual judgments of the phonation samples obtained before and after RVT by professional singers, SLPs with singing training, and SLPs without singing training</div></div><div><h3>Method</h3><div>Three groups of judges formed the participants of the study: group A (professional singers), group B (SLPs with singing training), and group C (SLPs without singing training). The judges were instructed to evaluate the perceptual vocal resonance in the voice samples of two groups of trained Carnatic classical singers.Among these groups, One group received RVT training, and their voice samples were obtained before and after the training, while the other group acted as a control. An auditory perceptual 3-point rating scale was used to rate the vocal resonance. Descriptive and inferential statistical analyses and inter-rater agreement tests were done to understand the auditory perceptual judgment of vocal resonance by the three groups of judges.</div></div><div><h3>Results</h3><div><span>The results of the Wilcoxon signed rank test indicated that the post-training auditory perceptual ratings by group A (│Z│ = 2.66; </span><em>P</em> = 0.008) and group B (│Z│ = 2.36; <em>P</em><span> = 0.018) were significantly different from their pre-training perceptual rating scores. The post-training ratings by group C were not statistically different compared to their pre-training scores. Also, good agreement levels were found on the weighted Cohen’s Kappa coefficient test performed on the judgments made by groups A and B</span><strong>.</strong></div></div><div><h3>Conclusion</h3><div>The listeners compare the voice samples to their own internal representations of a voice which would exclusively depend on the experiences of the listeners. In that way, the perception of intricate voice features of singers, like vocal resonance, could be challenging for SLPs with no experience in singing. The results of this study propose specific training in auditory perceptual judgments for SLPs to ensure efficient and independent service delivery to elite vocal performers like singers.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1413.e17-1413.e25"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9730723","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":"Acoustic Analysis of the Normal Voice in Classically Trained Vocal Professionals: A Cross-sectional Study.","authors":"Marin Čargo, Ema Babić Tomas, Ana Đanić Hadžibegović","doi":"10.1016/j.jvoice.2025.08.010","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.08.010","url":null,"abstract":"<p><strong>Introduction: </strong>Professional singers are often described as vocal athletes due to the intense vocal demands of their profession, which may lead to functional impairments affecting their quality of life and career. Acoustic analysis provides an objective and quantitative method to assess voice quality. This study aimed to analyze the acoustic and aerodynamic voice characteristics in professional classically trained singers without subjective vocal complaints, as such a sample has been rarely studied.</p><p><strong>Methods: </strong>This cross-sectional study included 88 professional singers, ranging from the early stages to many years of active careers, divided into five groups based on voice type. Acoustic analysis was conducted using the LingWAVES voice protocol. Participants were also examined with flexible fiberoptic laryngoscopy to ensure vocal health before testing.</p><p><strong>Results: </strong>All participants demonstrated satisfactory results for the s/z ratio, indicating good vocal control. Maximum Phonation Time (MPT) values were lower than normative values in the basses and baritones. The Dysphonia Severity Index (DSI) scores indicated excellent voice quality for all groups. However, shimmer values exceeded normative values in the majority of participants, and higher values of irregularity were also observed in male voices. The bass group revealed unexpectedly high F0 values.</p><p><strong>Conclusion: </strong>Our results suggest that the current protocol, which relies on speaking voice and sustained phonation tasks, may not reliably assess professional singing voices. Standard normative thresholds may therefore be unsuitable for this population. Future studies should develop adapted protocols with ecologically valid tasks, validate adapted normative values and/or create tools specifically tailored to the acoustic characteristics of classically trained singers.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976691","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":"Laying the Groundwork to Study the Heterogeneous Nature of Vocal Fatigue","authors":"Chaya Nanjundeswaran Ph.D., CCC-SLP ,&nbsp;Adrianna C. Shembel Ph.D., CCC-SLP","doi":"10.1016/j.jvoice.2022.07.008","DOIUrl":"10.1016/j.jvoice.2022.07.008","url":null,"abstract":"<div><div>Vocal fatigue has remained an elusive construct—despite its significant impact on communication, vocation, and quality of life. Current frameworks define vocal fatigue in the context of vocal demands and vocal demand-responses. However, the impact of factors like individuals’ baseline vocal fitness and perception of the demand are not well understood. What is also not well understood are the effects of specific vocal demand ingredients on an individual's vocal demand responses. Furthermore, current outcome measures utilized to capture vocal fatigue lack sensitivity and underlying mechanisms are poorly understood. These gaps have led to inconclusive next steps in how to best define, assess, monitor, and manage vocal fatigue. A conceptual framework is needed to study and better understand vocal fatigue constructs. Such a framework should consider the individual's baseline physiology, psychology, key vocal demand ingredients, and biophysiological mechanisms underlying demand responses. The objective of this paper is to help the reader better understand the complex and heterogeneous nature of vocal fatigue and its impact on reliable assessment and monitoring. Future studies will require better elucidation of vocal demand ingredients, will need more sensitive vocal demand response measures, and will need to take in to account an individual's baseline physiology and psychological factors.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1213-1224"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10656995","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":"Comparison of Outcome Measures (Subjective, Objective, and Patient-Based) in Laryngeal Dystonia Treatment With Botulinum Toxin A Injection","authors":"Christopher D. Dwyer ,&nbsp;Grant E. Gochman ,&nbsp;Clark A. Rosen ,&nbsp;VyVy N. Young ,&nbsp;Sarah L. Schneider","doi":"10.1016/j.jvoice.2023.03.019","DOIUrl":"10.1016/j.jvoice.2023.03.019","url":null,"abstract":"<div><h3>Background</h3><div>Outcome assessment in laryngeal dystonia<span><span> is hindered by lack of consensus on a core set of outcome measures to quantify treatment effect and disease severity on quality of life. Potential outcome measure domains include objective voice, clinician reported, and patient reported outcome measures (PROMs) for determining treatment success and longitudinal disease tracking. We aim to determine correlations between a selections of outcome measure tools following </span>Botulinum toxin injection.</span></div></div><div><h3>Methods</h3><div>A selection of instruments were administered to assess adductor laryngeal dystonia<span> patient outcomes before and after Botulinum toxin injection. Voice samples recorded using a cellular telephone application were used for objective acoustic measures (CPPS, acoustic voice quality index) and speech language pathologist<span> perceptual analysis (CAPE-V). Additionally, patients completed a PROMs battery consisting of the Voice Handicap Index-10, Communicative Participation Item Bank-10, OMNI-Vocal Effort Scale, 3 visual analog scale (VAS) questions. Changes in these outcome measures pre-post treatment were compared between each other and with a global rating of change questionnaire (GRCQ) using Spearman's rank correlation coefficients.</span></span></div></div><div><h3>Results</h3><div><span>Twenty six patients (20 female, mean age 57.7 years) participated. Using an anchor based GRCQ, patients reported Botox efficacy was the only outcome measure found to have significant correlation (</span><em>r</em> = 0.54, <em>P</em> = 0.022); all other outcome measures did not meet statistically significant correlation. Amongst the selected outcome tools, several moderate-strong correlations were identified, largely for outcome measures within the same domain. Most notable were correlations between the patient reported OMNI-VES and VAS questions (<em>r</em> &gt; 0.68, <em>P</em> &lt; 0.05), clinician CAPE-V strain and overall severity (<em>r</em> = 0.900, <em>P</em> &lt; 0.001), and acoustic voice quality index with sustained vowel CPPs (<em>r</em> = -0.797, <em>P</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>Correlation between outcome measures instruments used for patients with adductor laryngeal dystonia requires further attention. Weak correlations with an anchor based GRCQ were found for this study's selected outcome instruments. A select number of correlations were found between outcome instruments within each of the individual outcome measure domains (patient perception, clinical perception, objective acoustics), but there was largely a lack of correlation found for instruments between these three separate domains.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1302-1312"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9373839","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}