Journal of Voice最新文献

{"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":"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}

{"title":"Quality of Life Trajectories After Partial Laryngectomy Versus Total Laryngectomy Stratified by Voice Rehabilitation Success.","authors":"Sang Hoo Park, Younghac Kim, Eun-Hye Kim, Taek Yoon Cheong, Man Ki Chung, Han-Sin Jeong, Young-Ik Son, Nayeon Choi","doi":"10.1016/j.jvoice.2026.09.026","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.026","url":null,"abstract":"<p><strong>Background: </strong>Although partial laryngectomy (PL) is often preferred for functional preservation, long-term quality-of-life (QoL) outcomes after total laryngectomy (TL) may vary according to voice rehabilitation success. We compared five-year longitudinal QoL trajectories among PL, TL with successful voice rehabilitation (TL-S), and TL with failed rehabilitation (TL-F).</p><p><strong>Methods: </strong>Ninety-two patients were categorized into PL (n = 52), TL-S (n = 21), and TL-F (n = 19). QoL was assessed from baseline to 5 years postoperatively using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Head and Neck Cancer-Specific Module (EORTC QLQ-H&N35) at multiple intervals (pre-op, 1 month, 3 months, 1 year, 2 years, and 5 years). Longitudinal patterns were evaluated across multiple functional and symptom domains. Longitudinal within-group changes were analyzed using generalized estimating equations, and supplementary between-group comparisons at each time point were performed using the Kruskal-Wallis test.</p><p><strong>Results: </strong>By 5 years, the TL-S group showed a Summary Score comparable to that of the PL group, whereas global health status/QoL remained higher in the PL group. The TL-S group also showed more favorable Speech scores at 5 years, with swallowing outcomes approaching those of the PL group at later time points. In contrast, the TL-F group showed persistently higher swallowing-related burden, with broader symptom burden, including Social Contact problems and Financial Difficulties, remaining more pronounced over time.</p><p><strong>Conclusions: </strong>Voice rehabilitation status may be associated with long-term QoL patterns after laryngeal cancer surgery. Successful rehabilitation after TL may be associated with more favorable long-term QoL patterns, with outcomes in selected domains approaching those of the PL group, whereas unsuccessful rehabilitation may be associated with persistently poorer outcomes.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170836","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":"Laryngology Patient-Reported Outcome Measures and Demographics as Predictors of Dysphonia-Related Procedures.","authors":"Adam Beucler, Aditya Mahesh, Ohad Cohen, Meredith Tabangin, Rebecca J Howell, Aaron D Friedman","doi":"10.1016/j.jvoice.2026.09.044","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.044","url":null,"abstract":"<p><strong>Objectives: </strong>Patient-Reported Outcome Measures (PROMs) are popular in laryngology clinics. We hypothesized that certain PROMs and demographic data might identify which dysphonic patients are more likely to require a procedure by a laryngologist prior to initial examination.</p><p><strong>Methods: </strong>This study took place at one academic medical center laryngology clinic from September 2021 to October 2023. A prospectively collected new laryngology patient database was queried for a chief complaint inclusive of dysphonia; Vocal Handicap Index-10 (VHI-10), Reflux Symptom Index, and Glottal Function Index (GFI) scores; and a poststroboscopy diagnosis. A retrospective chart review was performed for patient age at presentation, sex, and subsequent dysphonia-related procedures (DRPs) (operating room or office). T tests /Wilcoxon rank sums/ Chi-square tests compared characteristics between patients having a DRP within 1 year of their first visit (DRP+) and patients who did not. Logistic regression models were used to identify predictors of procedure, and accuracy was assessed with receiver operator characteristic curves.</p><p><strong>Results: </strong>Five hundred seventy-seven dysphonic patients were identified; 174 (30.1%) were DRP+. This population was statistically significantly older, more likely to be male, more likely to have a chief complaint of only dysphonia (CCOD), and had greater VHI-10 and GFI scores. Multivariable analysis revealed that the VHI-10 score, the presence (versus absence) of CCOD, and patient sex maximized the area under the curve (0.74; 95% CI: 0.70-0.78).</p><p><strong>Conclusion: </strong>Higher VHI-10 scores, CCOD, and male sex may be predictive of the need for subsequent voice-related procedures in new dysphonia patients. These data may be useful for initial visit screening and triage in resource-constrained voice clinics.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170032","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":"Proposed Classification System for Office-based Blue Laser Tissue Effect in Reinke's Edema.","authors":"Abdul-Latif Hamdan, Jerome R Lechien, Patrick Abou Raji Feghali, Robert T Sataloff","doi":"10.1016/j.jvoice.2026.08.046","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.046","url":null,"abstract":"<p><strong>Objective: </strong>To describe a new classification system for blue laser-induced tissue effect in Reinke's edema (RE).</p><p><strong>Method: </strong>All video recordings of patients with RE who had undergone office-based blue laser therapy between October 2022 and May 2026 were reviewed, and a total of 16 video clips were selected to include the different types of tissue effects observed. Each video clip included a short segment showing part of the laser procedure and the immediate posttreatment tissue effect. The compiled video recordings were blindly rated by three board-certified laryngologists based on a 4-point proposed classification; Blanching of the mucosa with or without angiolysis (RE-BLL1); Blanching of the mucosa with epithelial disruption or violation (RE-BLL2); Epithelial disruption with submucosal tissue ablation/evaporation (RE-BLL3), and Epithelial disruption with submucosal tissue extraction/removal (RE-BLL4).</p><p><strong>Results: </strong>The overall agreement in rating among the three reviewers was 96.7% (58 of 60 ratings). The agreement in rating RE-BLL1 tokens was 100% (15 of 15 ratings), 93.3% for RE-BLL2 tokens (14 of 15 ratings), 93.3% for RE-BLL3 tokens (14 of 15 ratings), and 100% for RE-BLL4 tokens (15 of 15 ratings). All reviewers demonstrated 100% intra-rater agreement with their own classification of the unidentified repeated recordings. Inter-rater reliability among the three blinded reviewers was excellent. Using a two-way mixed-effects model with absolute agreement, the single-measure ICC was 0.975 (95% CI: 0.948-0.989), indicating excellent reliability of an individual reviewer's grading. The average-measure ICC was 0.991 (95% CI: 0.982-0.996), indicating excellent reliability when the three reviewers' scores were considered together.</p><p><strong>Conclusion: </strong>The proposed 4-point classification system for tissue effects of blue laser treatment of RE had an excellent inter-rater and intra-rater reliability. By standardizing the description of the blue laser-induced tissue effect in RE, this classification could help improve consistent communication among laryngologists and other voice care providers.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139055","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":"Investigating the Effects of Amateur Singing on Speaking Voice Quality, Function, and Motor Control Across Adulthood.","authors":"Amélie Nadeau, Pascale Tremblay, Maude Desjardins","doi":"10.1016/j.jvoice.2026.09.019","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.019","url":null,"abstract":"<p><strong>Objectives: </strong>Singing is an accessible activity that may promote vocal health, including vocal function, quality, and motor control. However, evidence remains limited and heterogeneous, as some studies have shown an association between singing practice and dysphonia-related complaints in certain populations. This study investigated whether amateur singing practice influences adult speaking voice outcomes related to function, quality, and motor control, and whether it may moderate age-related vocal changes.</p><p><strong>Methods: </strong>Participants were 143 French-speaking adults (20-98 years; 72 singers, 71 non-singers). Amateur singers were defined as individuals singing in a choir for at least two years with a minimal weekly practice of 60 minutes. Vocal function and quality were assessed using the Dysphonia Severity Index, Acoustic Voice Quality Index, speaking habitual intensity, and perceptual judgment of overall severity. Voice Onset Time (VOT) and its variability during a diadochokinetic task were used as proxies for vocal motor control. Linear and mixed-effects regression models tested the main effects of group (singers/non-singers), age, and their interaction, while controlling for relevant variables.</p><p><strong>Results: </strong>Singers exhibited higher harmonic-to-noise ratios and lower shimmer values than non-singers. Age predicted lower maximal fundamental frequency values, independent of singing status. A moderating effect of singing was found for overall severity ratings, showing a trend toward better perceptual vocal quality in younger and middle-aged singers, but not in older singers, resulting in a steeper association between age and overall severity among singers. Interactions also revealed differential associations between VOT and age in singers compared to non-singers for specific consonants, suggesting potential differences in laryngeal-articulatory coordination between groups.</p><p><strong>Conclusion: </strong>Findings suggest that amateur singing is associated with specific acoustic and perceptual benefits, although some of these associations may not be found in older adults. Longitudinal studies are needed to clarify the potential benefits of amateur singing.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149031","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}