Journal of Voice最新文献

{"title":"Uncertainty of Spatial Segmentation of High-Speed Videoendoscopy and Its Temporal and Spatial Dependency.","authors":"Hamzeh Ghasemzadeh, Maria E Powell, David S Ford, Dimitar D Deliyski","doi":"10.1016/j.jvoice.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.007","url":null,"abstract":"<p><strong>Objective: </strong>Spatial segmentation of high-speed videoendoscopy (HSV) is the process that detects the edges of the vocal folds and represents them in analytic form. The level of spatial segmentation uncertainty (ie, how close vs. far apart different experts marked the edges of the vocal folds) can have a great impact on the level of uncertainty of the final measures (ie, their dispersion). This study quantified the uncertainty of spatial segmentation and investigated its dependency on the phase of the glottal cycle and the location of vocal fold edges along the anterior-posterior direction.</p><p><strong>Method: </strong>Three experts manually segmented the vocal fold edges of twelve HSV recordings using an iterative process consisting of an initial segmentation followed by a blinded reconciliation phase. Segmentation uncertainty was computed as the distance in pixels between the three-segmented edges at the end of the iterative process. The relationships between segmentation uncertainty and different sections of the glottis along the anterior-posterior direction and the relationships between segmentation uncertainty and different phases of the glottal cycle were quantified.</p><p><strong>Results: </strong>Segmentation uncertainties of the anterior and the posterior sections of the glottis were significantly higher than the middle section, while uncertainty of the anterior section was the highest and 40% larger than the middle section. The average segmentation uncertainty and normalized glottal area were positively correlated. Segmentation uncertainty of the most open glottal configurations was 31% larger than the most closed glottal configuration.</p><p><strong>Conclusion: </strong>The uncertainty of spatial segmentation of the vocal fold edges depends on the phase of the glottal cycle and the location of the edge along the anterior-posterior direction; hence, it is expected for different HSV measures to have different levels of uncertainties. The implications of these findings for vocal fold velocity measures are discussed. Additionally, the findings from this study could provide direction for future automated spatial segmentation methods and for creating a robust and reliable automated HSV processing pipeline.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744109","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":"Examining the Influence of Cumulative Vocal Demands on Singing Performance in Music Students.","authors":"Tingting Sun, Yu Deng","doi":"10.1016/j.jvoice.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.001","url":null,"abstract":"<p><strong>Objective: </strong>The various vocal demands imposed on music students over the semester might impact their voice stability and performance. To maximize vocal health in music education, it is critical to understand how these demands influence voice quality. The research aimed to investigate how cumulative vocal demands affected the singing ability of voice majors in music during a semester. Aerodynamic and acoustic voice measurements were utilized to assess singing performance at several points throughout the semester. At these times, each participant was examined individually to detect variances in vocal performance.</p><p><strong>Methods: </strong>Utilizing a time-course design, data was examined using repeated measures and one-way within-participants analysis of variance to evaluate changes over time. Voice quality was evaluated using the wearable voice monitor, aerodynamic testing device, and voice analysis software. Self-reported information on voice problems and usage was also gathered. There were no statistically significant variations in the acoustic and aerodynamic characteristics of the participants' singing performances, even with the prolonged monitoring time.</p><p><strong>Results: </strong>Based on their self-reported statistics, the students demonstrated a reasonable level of knowledge of voice care and usage throughout the semester.</p><p><strong>Conclusion: </strong>The research indicates that voice students' singing performance was not significantly affected by the cumulative vocal demands of a semester, with their vocal characteristics remaining constant over time.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744099","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":"Retrospective Analysis of Short-Term Responses to PRP Injections for Patients With Vocal Fold Scars and Presbylaryngis.","authors":"Cecilia Bec, Ralph Haddad, Marie Cachi-Pouyenne, Alexia Mattei, Melanie Velier, Julie Veran, Gaelle Heleu, Chloe Dumoulin, Florence Sabatier, Justin Michel, Jeremy Magalon, Antoine Giovanni","doi":"10.1016/j.jvoice.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.012","url":null,"abstract":"<p><p>Vocal fold scarring and presbylarynx significantly impair voice quality, leading to a decline in patients' quality of life. These pathologies represent considerable challenges for laryngologists. Traditional treatments often produce suboptimal outcomes. Platelet-rich plasma (PRP) is an innovative, minimally invasive treatment that uses autologous biological material rich in growth factors and platelets, with positive effects on tissue regeneration and repair. Based on its promising effects, we started using PRP as a therapeutic option in vocal folds scars and presbylarynx. We performed a retrospective study on the efficacy and clinical outcomes of PRP injections performed in these patients. Between October 2021 and November 2023, 48 patients (35 women, 13 men; mean age 53 ± 15 years) were treated with PRP for a total of 109 injections for acute or chronic vocal fold lesions or presbylaryngis. PRP preparation followed a standardized protocol. The mean volume of PRP injected per vocal fold was 0.57 ± 0.30 mL, with high platelet purity (95.05% ± 3.48) found in PRP biological characterization. No adverse events were reported. The vocal outcomes assessed 1 month after the treatment found no modification in the acoustic parameters, but a significant improvement in the perceptual voice analysis on the G (P < 0.001), R (P = 0.005), and B (P = 0.008) of the GRB scale, and a clinical improvement on videolaryngostroboscopy for 62.5% of the patients. Most importantly, 70.8% of the patients reported subjective improvement with an average reduction in VHI-30 score of 10.79 points, with 32% of patients achieving clinically significant improvement (≥18 points). PRP injections demonstrate promising efficacy and safety in vocal fold scars and presbylaryngis treatment, with a significant improvement in perceptual voice analysis and subjective assessments. Further studies with larger cohorts and control groups are needed to confirm these findings and optimize PRP therapy protocols.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744107","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":"Voiced-Voiceless Consonant Distinction in Children With Vocal Fold Nodules: A Preliminary Study.","authors":"Meghan Littlejohn, Geralyn Harvey Woodnorth, Anne Hseu, Roger Nuss, Elizabeth Heller Murray","doi":"10.1016/j.jvoice.2025.02.045","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.045","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>The relationship between articulatory and vocal development is not well-understood in children with vocal fold nodules (VFN). Because these children have differences in their vocal system at a time when vocal-articulatory control is developing, it is important to understand this relationship. This study examined relationships between voiced and voiceless voice onset time (VOT) measures and cepstral peak prominence (CPP) in children with VFN (3-7 years old).</p><p><strong>Study design: </strong>Retrospective.</p><p><strong>Methods: </strong>Acoustic data were gathered from a retrospective dataset from children with VFN ages 3-5, 5-6, and 6-7 years old using words with initial /b/ and /p/ consonants. Correlations were completed for each age group and phoneme combination to examine the relationships between CPP and VOT percent overshoot, accuracy, range, variability, and discreteness. Additionally, Wilcoxon Signed-Rank tests were completed to facilitate interpretation of the data.</p><p><strong>Results: </strong>No relationship was found between CPP and VOT overshoot, accuracy, range, or variability. Significant findings indicated that children ages 5-6 and 6-7 with more dysphonia had less discreteness between /p/ and /b/. Wilcoxon Signed-Rank tests indicated significantly less discreteness for the 5-6-year-old group.</p><p><strong>Conclusions: </strong>Findings suggest that children with VFN and increased dysphonia may demonstrate decreased motor control, as evidenced by the relationship between CPP and discreteness. Future research can build on these findings by using a sample with more children, prospectively designed tokens, and a control group without VFN.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744185","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 Height a Contributing Factor of Laryngopharyngeal Reflux Disease? A Case-Series of 463 Patients.","authors":"Jérôme R Lechien","doi":"10.1016/j.jvoice.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.013","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the influence of height on pharyngeal reflux characteristics, clinical presentation, and therapeutic outcomes in patients with laryngopharyngeal reflux disease (LPRD).</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) were collected from the European Reflux Clinic and Elsan Hospital from January 2017 to October 2024. 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 stratified by patient height.</p><p><strong>Results: </strong>The study included 463 patients (257 females (55.5%) and 206 males (44.5%). The mean ages of females and males were 51.7 ± 15.4 and 50.4 ± 16.1, respectively. Females demonstrated higher frequency of weakly acidic pharyngeal reflux events and RSS compared to males. Height did not influence HEMII-pH parameters or endoscopic findings in either sex. However, shortest females reported higher baseline digestive symptoms and demonstrated higher 3-month post treatment RSA scores. In males, therapeutic response varied by height, with significant RSS improvements observed in groups <171 cm and 171-180 cm, while the tallest group showed no significant improvement.</p><p><strong>Conclusion: </strong>Height does not influence objective HEMII-pH findings. RSS did not differ across height-stratified cohorts, either at baseline or 3 months post treatment. Future studies should investigate the role of physiological, anatomical, and behavioral factors in height-related therapeutic variations.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744105","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":"Office-Based Blue Laser Therapy for Vocal Fold Cysts: A Case Series and Review of the Literature.","authors":"Abdul-Latif Hamdan, Marc Mourad, Randa Barazi, Zeina Maria Semaan, Patrick Abou Raji Feghali, Lana Ghzayel","doi":"10.1016/j.jvoice.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.005","url":null,"abstract":"<p><strong>Objective: </strong>To report a case series of vocal fold cysts treated with the blue laser in an office-setting and to review the literature on office-based laser therapy for vocal fold cysts.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>The medical records and video-recordings of all patients diagnosed with vocal fold cysts who underwent office-based blue laser therapy (OBLT) in a tertiary referral center between December 2023 and October 2024 were reviewed. Outcome measures included patient self-reported vocal handicap using the Voice Handicap Index-10 (VHI-10) questionnaire, disease regression as seen on laryngeal endoscopic examination, and acoustic and aerodynamic parameters.</p><p><strong>Results: </strong>A total of eight patients with vocal fold cysts underwent OBLT met the inclusion criteria. Five patients presented for follow-up and were included in this study. The mean follow-up period was 11.40 ± 11.61 weeks. There was a decrease in the VHI-10 score following treatment in all five cases, with a significant decrease in the mean score by 11.2 points (P = 0.009). There was complete disease regression on laryngeal examination in all five cases, with improvement in mucosal waves and glottic closure following surgery. There was a non-significant decrease in the perturbation parameters, jitter and shimmer, in the Voice Turbulence Index and noise-to-harmonic-ratio. There was also a non-significant increase in the maximum phonation time from 12.53 ± 7.12 to 16.03 ± 7.12 seconds.</p><p><strong>Conclusion: </strong>This study indicates that office-based blue laser surgery is effective in treating vocal fold cysts. The results support the growing evidence in the literature on the efficacious role of lasers in the management of vocal fold cyst in an office setting.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732750","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":"Accuracy of ChatGPT-4o in Text and Video Analysis of Laryngeal Malignant and Premalignant Diseases.","authors":"Carlos M Chiesa-Estomba, Maider Andueza-Guembe, Antonino Maniaci, Miguel Mayo-Yanez, Frank Betances-Reinoso, Luigi A Vaira, Alberto Maria Saibene, Jerome R Lechien","doi":"10.1016/j.jvoice.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.03.006","url":null,"abstract":"<p><strong>Introduction: </strong>Chatbot Generative Pretrained Transformer (ChatGPT), a multimodal generative AI, has been studied for potential applications in healthcare, including otolaryngology-head and neck surgery. In this study, authors investigates the consistency of ChatGPT-4o in analyzing clinical fiberoptic videos of suspected laryngeal malignancies compared to expert clinicians.</p><p><strong>Methods: </strong>This experimental study involved twenty patients with primary laryngeal disease consulting at a tertiary academic center. Data, including laryngeal fiberoptic video examinations, were retrospectively analyzed using the ChatGPT-4o application programming interface. Responses were assessed for diagnostic accuracy, consistency, and clinical recommendations. Three otolaryngology-head and neck consultants independently evaluated ChatGPT-4o's performance using the Artificial Intelligence Performance Instrument and a five-point Likert scale for complexity and consistency.</p><p><strong>Results: </strong>ChatGPT-4o identified malignant diagnoses as the primary diagnosis in 30% of cases, while proposing malignancies as one of the top three diagnoses in 90% of cases. Despite high sensitivity, specificity was limited. The mean consistency score for image analysis was 2.36 ± 1.13, with an intraclass correlation coefficient of 0.890 (P = 0.03). The model showed a tendency to prioritize text over visual data, limiting the improvement in diagnostic accuracy from video input.</p><p><strong>Conclusion: </strong>While ChatGPT-4o demonstrates potential in analyzing laryngeal pathologies through multimodal data, current limitations in specificity and image interpretation indicate the need for further refinement. Ongoing advancements could enhance its integration into clinical workflows, supporting accurate diagnoses and decision-making in otolaryngology.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732746","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":"Nanofat for Injection Laryngoplasty: A Preliminary Study of a New Substrate.","authors":"Sunder Gidumal, Diana Kirke, Benjamin Laitman, Sarah K Rapoport, Peak Woo","doi":"10.1016/j.jvoice.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.007","url":null,"abstract":"<p><strong>Objective: </strong>\"Nanofat\" refers to fat further emulsified into 1-µm sizes. It is commonly used in facial plastic surgery. Nanofat increases the release of adipose-derived stem cells. This study tested whether injection laryngoplasty using nanofat resulted in bulking and vibratory effects comparable to using microfat in treating patients with fold atrophy.</p><p><strong>Methods: </strong>This was a randomized, controlled, single-blind, prospective study of 18 patients with vocal atrophy who underwent transoral lipoinjection using microlaryngoscopy. The control group received bilateral microfat injection. The experimental group randomly received microfat in one vocal fold and nanofat in the contralateral vocal fold. The average volume of fat injected was 0.6 mL on each side. The postsurgery evaluation at 3 months included ratings of stroboscopy and acoustic recordings by blinded expert raters. Vibratory behavior, voice ratings, preVoice Handicap Index-10 (VHI-10) and postVHI-10 score, and Cepstral/Spectral Index of Dysphonia (CSID) were compared.</p><p><strong>Results: </strong>Significant improvement in the VHI at three-month follow-up was noted in all patients (n = 18 total, 12 experimental, six control). In the subgroup analysis, only the nanofat group significantly improved VHI. Improvements in the CSID were observed in both techniques; however, neither group showed statistical significance. Improved glottic closure was comparable in both groups. Expert raters observed an improvement in the voice quality of nanofat individuals but no change in microfat individuals.</p><p><strong>Conclusion: </strong>Lipoinjection laryngoplasty with nanofat may be an alternative to microfat in patients with vocal atrophy.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732748","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":"Translation and Adaptation to Hebrew of the Singers' Voice Handicap Index Questionnaire.","authors":"Ofer Amir, Shani Shteinberg","doi":"10.1016/j.jvoice.2025.02.041","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.041","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to present and validate the Hebrew version of the Singing Voice Handicap Index (SVHI-Heb). It also examined possible differences in voice handicap between professional singers and singing students and among singers of various singing styles.</p><p><strong>Methods: </strong>The original SVHI questionnaire was translated and adapted to Hebrew. The resulting Hebrew version was administered to 153 singers. Of them, 111 were professional singers, and 42 were singing students. The singers were also arranged according to their singing style to facilitate a comparison of voice handicap scores among four singing style groups (pop, rock, classical, and Mediterranean).</p><p><strong>Results: </strong>Internal consistency of the SVHI-Heb was high, with Cronbach's α = 0.96. Principle component analysis revealed a single factor on which all items were loaded, explaining 44.48% of the variance. A strong external validity was found between the questionnaire's scores and a four-point scale of voice disorder severity (r₍₁₅₁₎ = 0.79, P < 0.001). No significant group differences were found between the scores obtained for the professional singers and those obtained for the singing students. Similarly, no significant differences were found in the scores for the four singing style groups.</p><p><strong>Conclusions: </strong>The SVHI-Heb is a reliable and valid measure for capturing and assessing voice handicap in singers.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674685","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":"Impact of Upper Airway Narrowing on Patient Tolerance in Office-Based Blue Laser Surgery.","authors":"Abdul-Latif Hamdan, Marc Mourad, Patrick Abou Raji Feghali, Zeina Maria Semaan, Marwan Rizk, Omar Aboul Hosn, Jonathan Abou Chaar, Hani Tamim","doi":"10.1016/j.jvoice.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.015","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the impact of upper airway narrowing on patient tolerance in office-based laser surgery.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>All patients who underwent office-based blue laser surgery for benign and premalignant laryngeal lesions between November 2021 and September 2024 were reviewed. The Iowa Satisfaction with Anesthesia Scale questionnaire and the Visual analogue scale score for discomfort were used. Demographic data included age, gender, smoking, Body mass Index, comorbidities, and etiology of dysphonia. Four anatomical sites of the upper airway were evaluated for the presence of narrowing: the nose, nasopharynx, oro-/hypopharynx, and larynx.</p><p><strong>Results: </strong>A total of 89 patients were included. The most common site of upper airway narrowing was the nose in 74.1% of the cases. This was followed by the nasopharynx and oro-hypopharynx in 23.5% and 20.2% of the cases, respectively. Only 11 patients had laryngeal narrowing with the most common cause being prolapse of the epiglottis. The mean IOWA score of the study group was 1.5 ± 1.1. There was no significant difference in the mean IOWA score between those with or without laryngeal narrowing. The mean VAS score was 2.98 ± 2.47. There was also no significant difference in the mean VAS discomfort score in patients with or without upper airway narrowing, except in those with oro-/hypopharyngeal narrowing (P = 0.011).</p><p><strong>Conclusion: </strong>Upper airway narrowing had a nonsignificant impact on patient tolerance and discomfort. Nevertheless, patients with narrowing of the upper airway require diligent handling of the endoscope to reduce any potential discomfort.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674681","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}