Journal of Voice最新文献

{"title":"Examining the Relationships Between Vocal Fatigue and Voice-Related Quality of Life Among K-12 In-Service Music Teachers.","authors":"Kexin Xu","doi":"10.1016/j.jvoice.2026.09.054","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.054","url":null,"abstract":"<p><p>Music teachers depend on their voices for a variety of professional responsibilities. Despite the well-documented broader vocal health issues among music teachers, comparatively little is known about self-reported vocal fatigue and the impacts of voice problems on daily function and quality of life in this population. The purpose of this research was to investigate the relationships between self-reported vocal fatigue and two indicators of self-perceived vocal impacts, voice handicap and voice-related quality of life, among K-12 in-service music teachers. The second purpose was to examine whether vocal fatigue varied as a function of teaching contexts. Participants were 211 K-12 music teachers who were members of the National Association for Music Education. They completed an online questionnaire that included (1) demographic and background information, (2) Vocal Fatigue Index, (3) Voice Handicap Index-10, and (4) Voice-Related Quality of Life. Participants rated physical discomfort associated with voicing (factor 2) as closest to the established vocal fatigue threshold. Pearson correlation analyses revealed significant and positive correlations between tiredness of voice and avoidance of voice use (factor 1) and physical discomfort (factor 2) with voice handicap, and significant and negative correlations between factors 1 and 2 with voice-related quality of life. Participants reported lower degrees of tiredness of voice and physical discomfort also tended to report lower voice handicap and better voice-related quality of life. Tiredness of voice was the only significant predictor of voice handicap and voice-related quality of life. Participants who taught 1 to 5 years scored significantly higher on physical discomfort than those who taught for more than 15 years. When experiencing vocal fatigue, music teachers are recommended to use amplification, consult vocal health professionals, and seek organizational support from districts and mentors. Vocal health education should provide knowledge on healthy speaking, vocal health resources, and the roles of voice care professionals.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185589","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":"Voice Outcomes Following Behavioral Voice Therapy in Adults With Sulcus Vocalis: A Retrospective Controlled Study.","authors":"Jing Peng, Manwa L Ng, Mi Zou, Qiao Hou, Jie Tan, Qiannan Zhang","doi":"10.1016/j.jvoice.2026.09.035","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.035","url":null,"abstract":"<p><strong>Objective(s): </strong>To evaluate changes in voice outcomes associated with multicomponent individualized behavioral voice therapy in adults with sulcus vocalis.</p><p><strong>Study design: </strong>Retrospective controlled study.</p><p><strong>Methods: </strong>Thirty-four patients with sulcus vocalis diagnosed by videostroboscopic examination were retrospectively categorized into a vocal hygiene group (n = 17) and a voice therapy group (n = 17). Both groups received vocal hygiene education with continued home implementation for 2 months; the voice therapy group additionally received an 8-week multicomponent individualized behavioral voice therapy program. Voice outcomes were assessed before and after the intervention. Voice outcomes included GRBAS ratings, maximum phonation time (MPT), fundamental frequency (F0), jitter, shimmer, harmonics-to-noise ratio (HNR), cepstral peak prominence for sustained vowel /a/ (CPP-a) and connected-speech (CPP-s), Voice Handicap Index (VHI), and Vocal Fatigue Index (VFI). GRBAS ratings were analyzed using ordinal logistic generalized estimating equations, whereas continuous outcomes were analyzed using repeated-measures ANOVAs, Bonferroni-corrected within-group comparisons, and baseline-adjusted analyses.</p><p><strong>Results: </strong>For GRBAS ratings, significant group × time interactions were observed for G, B, and S, but not for R or A. G, B, and S decreased significantly in the voice therapy group, and post-intervention G and B were significantly lower than in the vocal hygiene group. For continuous outcomes, significant group × time interactions were observed for MPT, jitter, shimmer, HNR, CPP-a, VHI, and VFI, with baseline-adjusted post-intervention comparisons for these outcomes favoring the voice therapy group. No significant group × time interactions were observed for F0 or CPP-s.</p><p><strong>Conclusions: </strong>Compared with vocal hygiene education with home implementation, the additional voice therapy program was associated with greater improvements in perceptual voice quality, sustained phonatory capacity, selected acoustic measures, voice-related handicap, and vocal fatigue. These findings suggest a potential benefit of behavioral voice therapy for adults with sulcus vocalis.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185635","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":"Efficacy of Systemic Bevacizumab in Juvenile-Onset Recurrent Respiratory Papillomatosis: An Individual Patient Data Meta-Analysis.","authors":"David Hortobagyi, Doris-Maria Denk-Linnert, Marie Altmann, Katharina Valentinuzzi, Tanja Grossmann, Alexandra Kaider, Veronika Kranebitter","doi":"10.1016/j.jvoice.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.002","url":null,"abstract":"<p><strong>Objective: </strong>Juvenile-onset recurrent respiratory papillomatosis (joRRP) is a benign but often aggressive HPV-related disease of the pediatric airway, frequently requiring repeated surgical debulking. These repeated interventions are associated with substantial morbidity and impaired quality of life, particularly due to persistent dysphonia. Systemic bevacizumab, an anti-VEGF monoclonal antibody, has emerged as a promising adjuvant therapy, but individual patient-level evidence synthesizing its efficacy across studies is lacking.</p><p><strong>Methods: </strong>We performed an individual patient data meta-analysis to evaluate the effect of systemic bevacizumab on surgical intervention rates in patients with joRRP. Following a systematic search of four electronic databases, six studies comprising 33 patients met eligibility criteria. Thirty patients with documented follow-up duration were included in the primary analysis. Surgical rates before and after bevacizumab initiation were compared using a generalized linear mixed model with a negative binomial distribution and log link, with follow-up duration as an offset. Changes in Derkay scores were assessed using the paired Wilcoxon signed-rank test.</p><p><strong>Resuts: </strong>Prior to treatment, patients had undergone a median of 16 surgical interventions (IQR 5-32). The estimated surgical rate decreased from 38.6 to 1.8 procedures per 100 patient-months after bevacizumab initiation, corresponding to a rate ratio of 0.047 (95% CI 0.017-0.128) and a relative reduction of 95.3% (P < 0.0001). Among nine patients with paired Derkay scores, the median score decreased from 8 (IQR 5-15) to 0 (IQR 0-1; P = 0.0039). Adverse events were mild, most commonly epistaxis and proteinuria, with no serious adverse events reported.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that systemic bevacizumab may substantially and safely reduce surgical burden in pediatric patients with aggressive joRRP.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165432","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":"Parkinson's Disease Detection Using Empirical Fourier Decomposition of Speech Signal.","authors":"Sudhansu Sekhar Nayak, Anand D Darji, Prashant K Shah, Juan Rafael Orozco-Arroyave","doi":"10.1016/j.jvoice.2026.09.051","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.051","url":null,"abstract":"<p><strong>Objectives: </strong>The advancement of speech-based automated systems for Parkinson's disease (PD) detection has attracted growing attention due to their potential use in telemonitoring health systems, as they provide a reliable, quick, cost-effective, and noninvasive solution. The objective of this study is to provide an innovative method based on the Empirical Fourier Decomposition (EFD) approach to discriminate between PD patients and healthy controls using speech signals.</p><p><strong>Methods: </strong>Speech signals produced by PD patients and healthy controls (HC) are decomposed into several modes using EFD. Resulting modes are used to automatically discriminate between PD and HC. From each of the decomposed signals, various statistical features, including mean, variance, skewness, and kurtosis, are extracted together with entropy-based measures including entropy, Renyi's entropy, and approximate entropy. Finally, the combination of features is evaluated. All experiments are performed considering isolated words and sustained vowels of the PC-GITA database. An independent test set is used to assess the generalization capabilities of the proposed method.</p><p><strong>Results: </strong>The Support Vector Machine (SVM) classifier obtained an accuracy of 93% using the word /apto/ and 95% using the vowel /i/ from the PC-GITA dataset. The same system, without any additional optimization or tuning, was used to classify subjects in the independent test set. The results obtained in this scenario yielded accuracies of up to 84% for isolated words. The proposed EFD technique incorporates an improved approach to segmenting the Fourier spectrum, combined with the use of a zero-phase filter bank. The segmentation strategy effectively overcomes the inconsistency issue and the trivial component problem by defining a predetermined number of components for signal decomposition. When compared to other decomposition approaches such as the Empirical Wavelet Transform (EWT), it is found that the EFD technique exhibits greater accuracy in decomposing signals with closely spaced modes.</p><p><strong>Conclusion: </strong>The experimental outcome shows that our proposed EFD-based features are suitable and resilient for automatic classification between PD patients and HC subjects.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185606","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 Utility of Aerodynamic Measures in Vocal Fold Augmentation Outcomes.","authors":"Kelly Zdrowak, Ammar A Rashied, Andrew Tkaczuk, Shaheen N Awan, Amanda I Gillespie","doi":"10.1016/j.jvoice.2026.08.029","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.029","url":null,"abstract":"<p><strong>Objective: </strong>Glottic insufficiency can result in respiratory-laryngeal dysfunction that contributes to dysphonia. Instrumental assessments complement patient- and clinician-reported evaluations. Aerodynamic measurements provide quantitative data to characterize phonatory function. This study aimed to determine whether preoperative phonatory aerodynamic measures are associated with outcomes following vocal fold medialization for glottic insufficiency.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent injection laryngoplasty or type 1 thyroplasty at the Emory Voice Center from 2022 to 2024 was analyzed for baseline and postprocedure phonatory aerodynamic measures (mean airflow during voicing [MADV]), breaths while speaking, speaking duration, and patient-reported outcomes (voice handicap index-10) to assess changes across procedures (N = 98). Patients underwent one or multiple procedures, but data were not stratified by type or sequence.</p><p><strong>Results: </strong>Patients who underwent a second augmentation procedure had significantly higher baseline MADV (M = 0.49 L/s, SD = 0.25) than those who had one procedure (M = 0.32 L/s, SD = 0.23; P = 0.01), and took fewer breaths to read a standard passage from baseline (M = 13.1, SD = 7.2) to post-procedure 1 (M = 9.9, SD = 4.5; P = 0.02) than the 1-procedure cohort. Across groups, VHI-10 scores improved from baseline (M = 29.9, SD = 8.7) to postprocedure 1 (M = 21.6, SD = 10.7; P = 0.0008), and further after procedure 2 (M = 10.9, SD = 10.5; P = 0.02).</p><p><strong>Conclusion: </strong>Higher baseline MADV was linked to requiring multiple procedures, suggesting it may help predict the number needed to achieve glottic sufficiency. Post-treatment improvements in airflow and the number of breaths while speaking highlight the clinical value of aerodynamic assessments in planning and evaluating intervention outcomes.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167842","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":"Conventional Versus Telepractice Delivery of Eclectic Voice Therapy in Hyperfunctional Voice Disorders: An Efficacy Study.","authors":"Ranjitha Kashyap Bannur Nanjundaswamy, Jayakumar Thirunavukkarasu","doi":"10.1016/j.jvoice.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.010","url":null,"abstract":"<p><strong>Objectives: </strong>Literature supports the use of eclectic voice therapy in the treatment of Hyperfunctional Voice Disorders (HFVD). Nevertheless, limited studies have assessed and compared outcomes of conventional and telepractice approaches in the management of HFVD. Therefore, the current study aimed to examine and compare the efficacy of an eclectic voice therapy program through conventional versus telepractice mode in HFVD.</p><p><strong>Method: </strong>In total, 40 individuals with HFVD aged 18-60 years attended 15 sessions of the eclectic voice therapy program, with each session lasting 40 minutes. About 20 participants in Group 1 received eclectic voice therapy via conventional mode, and 20 in Group 2 received it via telepractice. Stroboscopy examination was performed at pre and post therapy. Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) Kannada, Acoustic Voice Quality Index (AVQI), Voice Handicap Index in Kannada (VHI-K), and Vocal Fatigue Index in Kannada (VFI-K) were obtained at pre therapy, post therapy, and 2 follow-ups.</p><p><strong>Results: </strong>Stroboscopy revealed notable improvement, and CAPE-V, AVQI, VHI, and VFI decreased from pre therapy to post therapy and follow-up evaluations in both the groups. The Mann-Whitney U test revealed no significant differences between the 2 groups (P > 0.05). Friedman's test indicated an overall significant difference (P < 0.01) across all four time points within Groups 1 and 2.</p><p><strong>Conclusion: </strong>The current study provided evidence to support the efficacy of eclectic voice therapy in HFVD. Both the conventional and telepractice modes of voice therapy were equally effective in treating HFVD. However, future studies employing random assignment and a larger sample size are warranted to strengthen the generalizability of the findings.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166732","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":"Postoperative Voice Changes Over Time Following Endoscopic or Robotic Hemithyroidectomy.","authors":"Jooin Bang, Sang-Yeon Kim, Jun-Ook Park, Gwang-Soon Kim, Ja-Sung Bae, Jeong-Soo Kim, DaYun Hwang, Mi-Ran Shim, Dong-Il Sun","doi":"10.1016/j.jvoice.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.001","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative voice impairment is a common concern after thyroidectomy. However, postoperative voice recovery and its association with clinicopathologic factors remain unclear in robotic and endoscopic approaches. This study evaluated postoperative changes over time in perceptual, acoustic, aerodynamic, and patient-reported voice outcomes and identified recovery patterns according to clinicopathologic factors in both surgical approaches.</p><p><strong>Methods: </strong>We retrospectively reviewed 1106 patients who underwent minimally invasive thyroidectomy for thyroid malignancy between 2018 and 2025. Among them, 704 patients who underwent remote-access thyroidectomy were included, of whom 334 underwent endoscopic hemithyroidectomy and 370 underwent robotic hemithyroidectomy. Voice outcomes were assessed using perceptual, acoustic Multi-Dimensional Voice Program (MDVP) and pitch-related parameters, aerodynamic parameters, and the Thyroidectomy-related Voice and Symptom Questionnaire. Evaluations were performed preoperatively and at predefined postoperative intervals (<1 month, 1-3 months, and ≥3 months). Longitudinal changes in voice outcomes were analyzed across these time points according to clinicopathologic factors, including Body Mass Index (BMI), Central Neck Dissection (CND) status, and tumor size.</p><p><strong>Results: </strong>Perceptual voice parameters worsened during the early postoperative period in both groups but recovered by 3 months. However, the F-high parameter did not fully recover by 3 months (P = 0.002 and P < 0.001, respectively), whereas other MDVP and pitch-related parameters returned to baseline levels. Aerodynamic parameters also recovered after 3 months in both groups. Significant improvement in clinically relevant voice impairment over time was observed in patients with BMI <18.5 and 18.5-24.9, those who did not undergo CND, and those with tumors ≤ 1 cm.</p><p><strong>Conclusion: </strong>Voice function typically deteriorates in the early postoperative period following both robotic and endoscopic thyroidectomy but generally recovers to near-baseline levels within 3 months. Significant improvement in clinically relevant voice impairment over time was observed in patients with BMI <n 25, those who did not undergo CND, and those with tumors ≤ 1 cm.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168929","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 Effect of Foot Arch Morphology and Plantar Pressure Distribution on Craniovertebral Angle and Acoustic Voice Parameters Across Different Postures.","authors":"Buket Ayça Sözüçok, İsmail İlter Denizoğlu, Tolga Sözüçok, Atakan Songurlu, Seher Özyürek, Elif Şahin Orhon","doi":"10.1016/j.jvoice.2026.09.050","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.050","url":null,"abstract":"<p><strong>Objectives: </strong>Human voice is a holistic phenomenon shaped by whole-body biomechanics and the integrity of the kinetic chain. This study investigated the effects of foot arch morphology on the craniovertebral angle and acoustic voice parameters across four postural conditions, in the context of forefoot plantar pressure distribution.</p><p><strong>Methods: </strong>Seventeen female university students were classified into a neutral arch group (n = 7) and a pes planus group (n = 10) based on three-dimensional optical foot scanning. In each of four postural conditions defined as neutral, kyphotic, upright, and anterior sway, the craniovertebral angle was measured photogrammetrically, plantar pressure was recorded using a piezoresistive sensor platform, and acoustic parameters including fundamental frequency (F₀), jitter, shimmer, harmonics-to-noise ratio, first formant (F₁), second formant (F₂), and Cepstral Peak Prominence Smoothed were extracted using Praat software. Data were analyzed using the Mann-Whitney U test, Spearman rank-order correlation with Bonferroni correction, the Friedman test, and linear mixed-effects models.</p><p><strong>Results: </strong>The pes planus group showed numerically lower craniovertebral angle values across all postures, although between-group differences in this angle were not statistically significant, and lower F₀, F₁, F₂, and CPPS during text reading than the neutral arch group, with the most pronounced differences observed during anterior sway loading. Linear mixed-effects model analyses revealed that foot arch morphology had significant independent effects on F₀ (F(1, 62) = 12.734, P < 0.001), F₁ (F(1, 62) = 20.871, P < 0.001), F₂ (F(1, 62) = 25.665, P < 0.001), CPPS during text reading (F(1, 62) = 12.536, P < 0.001), and CPPS during sustained /a/ phonation (F(1, 62) = 6.019, P = 0.017), independent of posture type and forefoot pressure. Total forefoot pressure percentage showed a significant independent negative effect on CPPS during sustained /a/ phonation (F(1, 62) = 6.129, P = 0.016). Within-group Friedman tests showed that F₁ varied significantly across postures in both groups, whereas shimmer and CPPS during sustained /a/ phonation varied significantly only in the neutral arch group and F₂ varied significantly only in the pes planus group (χ² = 13.920, P = 0.003).</p><p><strong>Conclusion: </strong>Foot arch morphology was associated with acoustic voice parameters independently of posture and forefoot plantar pressure, and with a consistent but non-significant trend toward lower craniovertebral angle values. These findings suggest that the integrity of the myofascial and proprioceptive chain extending from the sole to the larynx may warrant consideration as a parameter in the holistic evaluation of voice.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170819","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":"Videolaryngostroboscopy to Therapy Translational Framework: Bridging Laryngeal Imaging and Voice Therapy via Biomechanical Inference.","authors":"Marcelo José Rodríguez-Cruz","doi":"10.1016/j.jvoice.2026.09.042","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.042","url":null,"abstract":"<p><strong>Objectives: </strong>A gap separates videolaryngostroboscopy (VLS) findings from therapy decisions in voice care. This article proposes a translational framework that converts VLS findings into biomechanically informed therapeutic targets and candidate voice therapy techniques, whether the examination is reported by an otolaryngologist or performed by the speech-language pathologist.</p><p><strong>Study design: </strong>Clinical framework development with translation tables and synthetic illustrative cases.</p><p><strong>Methods: </strong>The framework integrates the 2018 American Academy of Otolaryngology-Head and Neck Surgery Foundation guideline, which recommends laryngoscopy before voice therapy; the 2023 European Laryngological Society and Union of European Phoniatricians core dataset; and classical vocal fold biomechanics, complemented where stated by the author's Unified Theory of Phonation. Two published high-speed videoendoscopy biomarkers, the Empirical Distribution of Glottal Edges and the Laryngovibrogram, are adopted, and one original index, the Stiffness/Pliability Index, is proposed. Evidence is graded with Oxford Centre for Evidence-Based Medicine levels.</p><p><strong>Results: </strong>A translation matrix links eight VLS findings to therapeutic targets and five techniques: semi-occluded vocal tract exercises, resonant voice therapy, vocal function exercises, manual circumlaryngeal therapy, and easy phonation. Five glottic closure patterns are mapped to distinct biomechanical inferences. A biomechanical inference triad structures bedside reasoning, a decision algorithm with an explicit safety gate is proposed, and three synthetic cases (nodules, unilateral paralysis, scar) illustrate its use. Biomechanical Reference Values are offered as provisional tracking thresholds, explicitly not validated minimal clinically important differences.</p><p><strong>Conclusions: </strong>The framework gives clinicians a structured, shared language for moving from VLS findings to therapy plans. All translations are clinical inferences, not direct measurements of impact force or tissue stiffness; its indices, thresholds, and mappings are hypotheses that require reliability testing and prospective validation before routine clinical use.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171823","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 Botulinum Toxin Versus Steroid Injection for Recurrent Laryngeal Contact Granuloma.","authors":"Shufang Zhang, Jie Shan, Qian Nie, Mingjie Zhang, Mengjun Wang, Cancan Wu, Yaru Sang","doi":"10.1016/j.jvoice.2026.09.053","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.053","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy of botulinum toxin injection versus steroid injection in the treatment of patients with recurrent laryngeal contact granuloma.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data from 44 patients with recurrent laryngeal contact granuloma who received either botulinum toxin injection or steroid injection between August 2021 and April 2026. Patients were divided into a botulinum toxin injection group and a steroid injection group. The cure rate, recurrence rate, and time to cure were compared between the two groups to determine the optimal treatment for patients with recurrent lesions.</p><p><strong>Results: </strong>In patients with recurrent granulomas, the botulinum toxin injection group demonstrated a higher cure rate (90%) and a lower recurrence rate (0%) compared with the steroid injection group (cure rate: 76.47%; recurrence rate: 11.54%), although the differences were not statistically significant (P > 0.05). The time to cure in the steroid injection group was significantly longer than that in the botulinum toxin injection group (P < 0.01).</p><p><strong>Conclusion: </strong>In patients with recurrent laryngeal contact granuloma, botulinum toxin injection was associated with a shorter time to cure compared with steroid injection. Botulinum toxin injection is an effective treatment for recurrent granulomas.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168948","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}