{"title":"Analysis and Categorization of Various Types of Vocal Distortion in Rock, Metal, Pop Styles, and Throat Singing Observed by High-Speed Digital Imaging.","authors":"Yogaku Lee, Masato Tanaka, Hikari Kato, Takashi Nakagawa, Satoshi Ishikawa, Tokihiko Kaburagi","doi":"10.1016/j.jvoice.2024.11.041","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.11.041","url":null,"abstract":"<p><strong>Introduction: </strong>Vocal distortion, also known as a scream or growl, is used worldwide as an essential technique in singing, especially in rock and metal, and as an ethnic voice in Mongolian singing. However, the production mechanism of vocal distortion is not yet clearly understood owing to limited research on the behavior of the larynx, which is the source of the distorted voice.</p><p><strong>Objectives: </strong>This study used high-speed digital imaging (HSDI) to observe the larynx of professional singers with exceptional singing skills and determine the laryngeal dynamics in the voice production of various vocal distortions. In addition, this study aimed to classify vocal distortions based on laryngeal dynamics.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>The dynamic behavior of the larynx of six singers (four males and two females) was recorded using HSDI, with the majority of recordings captured at frame rates exceeding 8000 fps. The audio signals were recorded simultaneously. The data were analyzed as topography, glottal area waveforms, long-term average spectra, and spectrograms.</p><p><strong>Results: </strong>Our analysis revealed that, based on the laryngeal vibration pattern, vocal distortion could be categorized into two primary groups: \"periodic\" and \"aperiodic.\" In the \"periodic\" distorted vocalizations, it was suggested that the glottal sound source containing overtone components is generated by vocal fold vibrations, and subharmonic components in the voice are the result of amplitude modulation of the glottal jet by vibrations in the supraglottic region. However, \"aperiodic\" distorted vocalizations were found to be generated by the vocal folds, which are the main source of noise and generate strong noise due to aperiodic chaotic oscillations of the vocal folds.</p><p><strong>Conclusion: </strong>The diversity of distorted vocalizations is due to the physiologically and acoustically complex mechanism of voice production in the larynx.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958174","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}
Journal of VoicePub Date : 2025-01-08DOI: 10.1016/j.jvoice.2024.12.033
Ingo R Titze
{"title":"Aerodynamic and Acoustic Power in Infant Cry.","authors":"Ingo R Titze","doi":"10.1016/j.jvoice.2024.12.033","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.12.033","url":null,"abstract":"<p><strong>Objectives: </strong>Acoustic and aerodynamic powers in infant cry are not scaled downward with body size or vocal tract size. The objective here was to show that high lung pressures and impedance matching are used to produce power levels comparable to those in adults.</p><p><strong>Study design and methodology: </strong>A computational model was used to obtain power distributions along the infant airway. The parameters were cross-sectional areas of the larynx canal and the velar region, which tend to be variable in infant cry when there is no specific vowel structure.</p><p><strong>Results: </strong>Aerodynamic power can reach 1.0 W with 70 cm H<sub>2</sub>O lung pressure, while acoustic power radiated from the mouth reaches about 1.0 mW, corresponding to 90 dB sound level at 30 cm from the mouth. Acoustic evidence of potential roughness is introduced with a narrow larynx canal (epilaryngeal airway).</p><p><strong>Conclusions: </strong>Infants are born with the ability to produce high lung pressures to compensate for reduced airflow in a small vocal tract. Airflow impedances are about 100 times higher than in adults. Maximum power transfer from the source to the airway (and ultimately to the listener) appears to be an innate ability.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958172","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}
Journal of VoicePub Date : 2025-01-08DOI: 10.1016/j.jvoice.2024.12.017
Puyang Geng, Ningxue Fan, Rong Ling, Zhijun Li, Hong Guo
{"title":"An Electroglottographic and Acoustic Study on Mandarin Speech in Male Heroin Users.","authors":"Puyang Geng, Ningxue Fan, Rong Ling, Zhijun Li, Hong Guo","doi":"10.1016/j.jvoice.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.12.017","url":null,"abstract":"<p><p>Drug abuse can cause severe damage to the human speech organs. The vocal folds are one of the important speech organs that produce voice through vibration when airflow passes through. Previous studies have reported the negative effects of drugs on speech organs, including the vocal folds, but there is still limited research on relevant field. Therefore, the current study recruited 25 heroin users and 30 healthy controls with no history of drug use. Electroglottography and speech signals of 26 target sentences were collected from all participants. The results of the current study showed that the heroin group exhibited higher DFx1 and H1-A3, and lower DAx1 and jitter, and lower F1 frequency for /a/ and F2 frequency for /i/, but higher F2 frequency for /u/ compared to the no drug group. These findings suggested the presence of vocal hoarseness, frequency and amplitude distributions that differed from the norm, and a limited range of tongue movement in the heroin group. This study not only enhances the understanding of the effects of heroin on speech production but also has implications for detoxification treatment and speech rehabilitation for drug users.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958173","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}
Journal of VoicePub Date : 2025-01-08DOI: 10.1016/j.jvoice.2024.03.014
Sibel Ozmen, Maral Yesilyurt, Kursat Yelken
{"title":"Muslim Religious Officials Have Less Voice Training and Higher Rate of Voice Disorder Than Christian Religious Officials.","authors":"Sibel Ozmen, Maral Yesilyurt, Kursat Yelken","doi":"10.1016/j.jvoice.2024.03.014","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.03.014","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the Voice Handicap Index-10 Scores, voice hygiene habits, and voice training of Christian and Muslim religious officials living in Turkiye.</p><p><strong>Method: </strong>In this study, a mixed method, including quantitative and qualitative research, was used. The population of the research consists of Christian and Muslim religious officials working in Turkiye.</p><p><strong>Sample: </strong>a total of 40 participants, including 20 Muslim religious officials, 15 imam-hatips, and 5 muezzin-trustees, determined by random sampling method, and 20 Christian religious officials, 15 priests and 5 ministers, determined by snowball sampling method were included.</p><p><strong>Results: </strong>There was a statistically significant difference in the total scores of the Voice Handicap Index-10 scale between Muslim and Christian religious officials. There was no statistically significant difference between Muslim religious officials and Christian religious officials in terms of whether they had a voice disorder before starting their profession, Muslim religious officials had a significantly higher rate of voice disorders than Christian religious officials after they started their profession. It was observed that there was no statistically significant difference between Muslim religious officials and Christian religious officials in terms of daily water, tea, coffee, and tobacco use. All of the Christian religious officials and some of the Muslim religious officials have received musical education at some point in their lives.</p><p><strong>Conclusion: </strong>On the basis of Voice Handicap Index-10 scores and voice hygiene habits evaluation, Muslim religious officials have higher rate of voice disorder than Christian religious officials. Regarding voice training evaluation, Muslim religious officials had less voice training, as they did not include voice and music education in their vocational education curriculum, while Christian religious officials received both.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957146","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}
Journal of VoicePub Date : 2025-01-07DOI: 10.1016/j.jvoice.2024.12.038
Michelle M Bretl, Ronald C Scherer
{"title":"Vocal Instabilities in Untrained Female Singers.","authors":"Michelle M Bretl, Ronald C Scherer","doi":"10.1016/j.jvoice.2024.12.038","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.12.038","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify voice instabilities across registration shifts produced by untrained female singers and describe them relative to changes in fundamental frequency, airflow, intensity, inferred adduction, and acoustic spectra.</p><p><strong>Study design: </strong>Multisignal descriptive study.</p><p><strong>Methods: </strong>Five untrained female singers sang up to 30 repetitions of octave scales. They first produced these octave scales \"naturally,\" followed by productions that were either deliberately smooth or deliberately unsteady. With all types of scale productions, participants sang with both /α/ and /i/ vowels, at two different dynamic levels, and across both the upper and lower predetermined register transitions. Recorded scales were categorized into three groups (Smooth, Middle, Unsteady) based on researcher-based perceptual smoothness of the auditory signals. These groups allowed for determination of salient features of unsteadiness based on observations and analyses of the acoustic, airflow, intensity, and electroglottography (EGG) waveforms.</p><p><strong>Results: </strong>A total of 13 different types of instabilities were observed. The number of instabilities within a single scale ranged from zero to fourteen. Most Smooth scales had zero to three instabilities, most Middle scales had four to six, and most Unsteady scales had six or more instabilities within the scale. More obvious instabilities, such as aphonic segments, were present only in Unsteady scales, while more subtle instabilities, such as those related to EGG signal changes, were common in all scale categories, including Smooth scales.</p><p><strong>Conclusions: </strong>This study revealed that untrained singers can sing smoothly throughout octave scales, and the primary unsteadiness variable was an aphonic segment and corresponding abrupt and large intensity reduction. Particular instabilities may be related to subtle aspects of register change and vocal control. Some objective measures appear to be more visually and numerically salient than auditorily perceived events relative to unsteadiness in the production of scales.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957895","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}
Journal of VoicePub Date : 2025-01-07DOI: 10.1016/j.jvoice.2024.12.009
Pervin Gulsen, Abdulkadir Gulsen, Mustafa Alci
{"title":"Machine Learning Models With Hyperparameter Optimization for Voice Pathology Classification on Saarbrücken Voice Database.","authors":"Pervin Gulsen, Abdulkadir Gulsen, Mustafa Alci","doi":"10.1016/j.jvoice.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.12.009","url":null,"abstract":"<p><p>Early diagnosis and referral are crucial in the treatment of voice disorders. Contemporary investigations have indicated the efficacy of voice pathology detection systems in significantly contributing to the evaluation of voice disorders, facilitating early diagnosis of such pathologies. These systems leverage machine learning methodologies, widely applied across diverse domains, and exhibit particular potential in the realm of voice pathology classification. However, machine learning models and performance metrics employed in these studies vary significantly, making it challenging to determine the optimal model for voice pathology classification. In this study, healthy and pathological voices were classified with state-of-the-art machine learning models, and the performance results of the models were compared. The voice samples employed in our research were sourced from the Saarbrücken Voice Database, a reputable German database. Feature extraction from voice signals was conducted using the Mel Frequency Cepstral Coefficients method. To assess and enhance the models' performance adequately, we employed hyperparameter optimization and implemented a 10-fold cross-validation approach. The outcomes revealed that the support vector machine model exhibited the highest accuracy, achieving 99.19% and 99.50% accuracies in the classification of male and female voice pathologies, respectively.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958176","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}
Journal of VoicePub Date : 2025-01-04DOI: 10.1016/j.jvoice.2024.12.018
Christopher S Apfelbach, Lady Catherine Cantor-Cutiva, Adrián Castillo-Allendes, Eric J Hunter
{"title":"Techniques, Models, and Variables of Interest in Studies of Intrinsic Laryngeal Muscle Fiber Types: A Bibliometric Analysis.","authors":"Christopher S Apfelbach, Lady Catherine Cantor-Cutiva, Adrián Castillo-Allendes, Eric J Hunter","doi":"10.1016/j.jvoice.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.12.018","url":null,"abstract":"<p><strong>Introduction: </strong>Laryngeal muscle physiology is integral to many speech, voice, swallowing, and respiratory functions. A key determinant of a muscle's contractile properties, including its fatigue profile and capacity for force production, is the myosin heavy chain (MyHC) isoform that predominates in the muscle. This study surveys literature on the MyHC compositions of mammalian intrinsic laryngeal skeletal muscle to illustrate trends and gaps in laryngeal muscle fiber typing techniques, models, and concepts.</p><p><strong>Methods: </strong>The Embase, Scopus, Medline, Web of Science, and Cochrane databases were systematically searched for studies of mammalian intrinsic laryngeal muscle MyHC composition. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews, 1531 non-duplicate papers were identified; 146 were selected for full-text screening. One hundred twenty papers were included in the final bibliometric analysis, which aimed to highlight key concepts in the literature.</p><p><strong>Results: </strong>Publication of intrinsic laryngeal MyHC studies peaked in the early 2000s and has since declined. Although early research predominantly used histochemical techniques and large mammalian models (cow, sheep, dog, horse, etc), practice has evolved to focus on electrophoretic, immunohistochemical, and transcriptomic fiber typing techniques in rats and humans. Comparatively few studies have examined how experimental manipulations affect laryngeal muscle MyHC composition.</p><p><strong>Discussion: </strong>Three areas of laryngeal muscle physiology lack a large body of supporting literature: (1) MyHC responses to stimuli such as training and disease, (2) MyHC plasticity across the lifespan, and (3) MyHC heterogeneity within muscle fibers (MyHC polymorphisms) and across muscle fibers (topographical MyHC distribution). We propose new avenues for research, education, and discussion in these three subdomains.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932812","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":"Cepstral Peak Prominence: A Valuable Measure of Voice Outcome Severity in Patients With Unilateral Vocal Fold Paralysis.","authors":"Jing-Yi Jiang, Pei-Min Hsu, Yi-An Pan, Yi-Hsuan Yu, Chin-Kuo Chen, Li-Chun Hsieh","doi":"10.1016/j.jvoice.2024.11.031","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.11.031","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the relationship between the position of the paralyzed vocal fold and voice quality in patients with unilateral vocal fold paralysis (UVFP) and identified a reliable acoustic analysis tool to enhance the accuracy of voice quality assessments in this population.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted with 70 patients with UVFP diagnosed at Mackay Memorial Hospital. Acoustic features-jitter, shimmer, the harmonic-to-noise ratio (HNR), and the cepstral peak prominence smoothed (CPPs)-were analyzed using the Praat software. A speech-language pathologist performed an auditory-perceptual assessment by using a perceptual voice evaluation scale, and a senior laryngologist reviewed the paralyzed fold's position endoscopically. Spearman's linear regression analysis was used to examine correlations between perceptual and acoustic parameters and the position of the paralyzed vocal fold.</p><p><strong>Results: </strong>The position of the paralyzed vocal fold exhibited weak correlations with acoustic and auditory-perceptual variables (r = 0.205-0.39). By contrast, moderate-to-strong correlations were discovered between auditory-perceptual variables and acoustic parameters (r = 0.378-0.803). Notably, the CPPs was more strongly associated with overall grade (severity: r = 0.673) and breathiness (r = -0.803) than with jitter, shimmer, and the HNR (r = 0.378-0.614).</p><p><strong>Conclusions: </strong>The position of the paralyzed vocal fold alone is insufficient for predicting voice outcomes in patients with UVFP. The CPPs is a more valuable indicator of perceived dysphonia severity, particularly in cases with audible breathiness, making it superior to jitter, shimmer, and the HNR for perceptual voice assessments in patients with UVFP.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932846","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}
Journal of VoicePub Date : 2025-01-03DOI: 10.1016/j.jvoice.2024.11.038
Isabel López-Sánchez, Ainhoa García-Lliberós, Rosa Hernández-Sandemetrio, Natsuki Oishi, Enrique Zapater
{"title":"Anatomical Study of the Larynx With Implications for Medialization Thyroplasty.","authors":"Isabel López-Sánchez, Ainhoa García-Lliberós, Rosa Hernández-Sandemetrio, Natsuki Oishi, Enrique Zapater","doi":"10.1016/j.jvoice.2024.11.038","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.11.038","url":null,"abstract":"<p><strong>Objetives: </strong>Montgomery medialization thyroplasty involves fitting a silicone prosthesis in the thyroid cartilage according to gender-based placement criteria. This standardized procedure can lead in some cases to suboptimal results. The aim of this study is to identify individual anatomical differences between same-gender patients that could explain the occasional failures.</p><p><strong>Methods: </strong>A prospective anatomical study was performed using 28 human laryngeal specimens (14 male, 14 female) obtained by clinical necropsy. Different measures on the thyroid ala were taken in order to describe the morphology of the thyroid cartilage and the location of the vocal fold: the distance between the superior thyroid notch and the inferior thyroid border (A), the distance between inferior thyroid border and inferior tubercle of the thyroid cartilage (B), the projection of the vocal fold into the thyroid ala including the distance between the anterior commissure and the inferior border of the thyroid cartilage (D1), and the distance between the projection of the vocal process of the arytenoid and the laryngeal tubercle (D2). Statistical analysis was performed to determine the relationship between gender and the mentioned measurements. A P value of 0.05 was considered statistically significant.</p><p><strong>Results: </strong>High rates of interindividual anatomical variability were observed irrespective of gender. In male samples, measurements A, B, D1, and D2 varied up to 5, 10, 8, and 8 mm respectively. Variability was even more evident in female larynges which varied up to 11, 7, 8, and 9 mm, respectively. The results of the measurements were similar between male and female.</p><p><strong>Conclusion: </strong>Montgomery thyroplasty failures can be due to individual anatomical variations regardless of gender. Based on our results, there is a significant interindividual anatomical variability irrespective of gender, even more evident among women. Customizing the location of the prosthesis may be an efficient way to solve this difficulty.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928485","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}
Journal of VoicePub Date : 2025-01-03DOI: 10.1016/j.jvoice.2024.12.015
Jenny L Pierce, Brendan Olson, Ray M Merrill, Jan Pierce, Anika Isom, Vanessa Torrecillas, Hilary McCrary, Alana Aylward, Marshall E Smith, M Ben Christensen
{"title":"Amniotic Fluid as a Potential Treatment for Vocal Fold Scar in a Rabbit Model.","authors":"Jenny L Pierce, Brendan Olson, Ray M Merrill, Jan Pierce, Anika Isom, Vanessa Torrecillas, Hilary McCrary, Alana Aylward, Marshall E Smith, M Ben Christensen","doi":"10.1016/j.jvoice.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.12.015","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>Vocal fold (VF) injury and chronic inflammation can progress to scarring, which is notoriously difficult to treat. Human amniotic fluid (AF) has potential for VF wound healing in a rabbit model, and we hypothesized that AF would demonstrate wound healing properties superior to hyaluronic acid (HA) over time.</p><p><strong>Study design: </strong>Randomized, controlled trial.</p><p><strong>Methods: </strong>In this pilot study, 60 New Zealand white rabbits (10 rabbits in each of six groups) received unilateral VF biopsy and immediate injection treatment of AF, HA, or saline (SA). The contralateral VF served as an uninjured control. Rabbits were sacrificed and VFs removed at 4 or 10 weeks postinjury. Rheology and reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) were employed to assess viscoelastic properties and inflammation, respectively.</p><p><strong>Results: </strong>Rheology differences were seen between four and 10 weeks postinjury in treatment groups but not in controls. Values for the AF treatment group differed from the SA and HA groups at week 10 (elastic P = 0.0002, viscous P < 0.0001). RT-qPCR: AF and HA had higher levels of inflammatory cytokines than SA at week 4 [TNFα: SA4 < HA4 (P = 0.0086), SA4 < AF4 (P = 0.0112)]. Presumptive inflammation was still present at 10 weeks in all treatment groups [IL-1β: AF control < AF (P = 0.0002), SA control < SA (P = 0.0212); IL-6: HA control < HA (P = 0.0312)]. AF demonstrated reduced inflammation at 10 weeks compared with SA [IL-6: SA > AF (P = 0.0141)]. AF was the only treatment group that had significant reductions in inflammation at 10 versus 4 weeks [IL-1β: AF4 > AF10 (P = 0.0249)].</p><p><strong>Conclusions: </strong>The main finding from this pilot study was that AF demonstrated wound healing effects over time compared with HA and SA by reducing inflammation and improving VF viscoelastic properties. Continued research to further investigate the use of AF in VF wound healing over longer periods of time is necessary before translation to human VFs.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928482","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}