Journal of Voice最新文献

{"title":"Pulmonary Function, Functional Capacity, Voice, and Sleep in Post-COVID-19 Individuals With and Without Inspiratory Muscle Weakness.","authors":"Marthina Carbone Dos Santos, Thamires Alessandra Silveira da Silva, Alessandra Hofstadler Deiques Fleig, Carla Aparecida Cielo, Carine Cristina Callegaro","doi":"10.1016/j.jvoice.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.011","url":null,"abstract":"<p><strong>Objective: </strong>To compare pulmonary function, functional capacity, voice, and sleep in post-COVID-19 individuals with and without inspiratory muscle weakness, as well as to investigate the association between vocal deviations, respiratory muscle strength, pulmonary function, functional capacity, and sleep parameters.</p><p><strong>Methods: </strong>Cross-sectional study with 28 post-COVID-19 adults, distributed into groups with (n = 14) and without (n = 14) inspiratory muscle weakness (maximal inspiratory pressure -MIP-<70% of the predicted value). Pulmonary function was assessed by spirometry; respiratory muscle strength by maximal respiratory pressures; inspiratory muscle endurance with a load of 60% of MIP; functional capacity by the Six-Minute Walk Test; and fatigue by the Fatigue Severity Scale and Chalder Fatigue Scale; voice was assessed using the Vocal Handicap Index (VHI), Vocal Fatigue Index (VFI), and Maximum Phonation Time (MPT); and sleep was assessed using the Insomnia Severity Index, Epworth Sleepiness Scale, and nocturnal oximetry.</p><p><strong>Results: </strong>Individuals with inspiratory muscle weakness presented a higher prevalence of fatigue (P = 0.02), higher scores in the physical domain (P = 0.008) and in the total VHI score (P = 0.01), greater occurrence of vocal functional impact (functional domain of the VHI) when analyzed in a categorized way (P = 0.02), higher scores in the VFI (factor one P = 0.008; factor two P = 0.002; factor three P = 0.002; total score P = 0.03), and lower MPT of the phonemes /s/ and /z/ (P = 0.02; P = 0.03) when analyzing continuous and categorical variables. A negative correlation was observed between the total VFI score and MIP (r = -0.467; P = 0.01), as well as between the VFI and the percentage of predicted MIP (r = -0.396; P = 0.03), indicating that lower levels of inspiratory muscle strength were associated with greater vocal fatigue.</p><p><strong>Conclusion: </strong>Inspiratory muscle weakness in post-COVID-19 individuals is associated with greater fatigue and poorer vocal outcomes, underscoring the importance of respiratory assessment in understanding the interaction between breathing and voice.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129106","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":"Divergent HNR and CPP Aging Trajectories in Korean Connected Speech.","authors":"Tae-Jin Yoon, Ji Hye Yoon, Seung Jin Lee, Woojae Han, Jungmin So, Seunghee Ha","doi":"10.1016/j.jvoice.2026.09.014","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.014","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to characterize acoustic aging patterns in Korean connected speech using ecologically valid, tablet-based recordings collected in home environments.</p><p><strong>Method: </strong>A total of 207 healthy older adults aged 50-81 years (77 male, 130 female; mean age 61.0 years) completed a standardized paragraph reading task, which was recorded using Samsung Galaxy tablets in their home environments.</p><p><strong>Results: </strong>Multiple linear regression identified distinct age-related trajectories across acoustic measures. Specifically, significant age-related increases were observed in perturbation and harmonic structure, including harmonics-to-noise ratio, jitter RAP, shimmer APQ3, and jitter PPQ5. Conversely, both mean fundamental frequency (F0) and cepstral peak prominence (CPP mean) significantly decreased with age. The age-related F0 decline was driven primarily by female speakers. No significant Age×Gender interactions were detected, although the smaller male subsample limited statistical power to detect such interactions, so this null result does not establish that the trajectories are equivalent. Notably, HNR increased while CPP simultaneously decreased with age, a divergence that contrasts with the sustained vowel literature and that we tentatively interpret as possible compensatory hyperadduction.</p><p><strong>Conclusion: </strong>Overall, the results show that tablet-based home recordings can yield interpretable age-related acoustic patterns in connected speech and support scalable data collection for acoustic aging research; test-retest reliability and device/environment effects should be quantified in future work.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117641","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":"Correlation Between Sleep and Voice Disorders in Patients with Fibromyalgia.","authors":"Abdul-Latif Hamdan, Lana Ghzayel, Valerie Sarkis, Rita Jreige, Sarah Kamareddine, Nijad Zeineddine, Lucien Khalil, Rita Maria Jalkh, Zeina Maria Semaan, Imad Uthman","doi":"10.1016/j.jvoice.2026.09.045","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.045","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the link between sleep and voice disorders in patients with fibromyalgia syndrome (FMS).</p><p><strong>Study design: </strong>Cross-sectional METHOD: Adult patients aged 18 to 65 years with a diagnosis of FMS were recruited from the Rheumatology Clinic of a tertiary referral center between April 2026 and June 2026. Fibromyalgia syndrome was diagnosed by a board-certified rheumatologist based on the 2016 American College of Rheumatology diagnostic criteria. Secondary outcome measures included the Voice Handicap Index-10 (VHI-10) and the Visual Analog Scale (VAS) for hoarseness.</p><p><strong>Results: </strong>A total of 101 patients, 63 patients with FMS and 38 controls, were included in the study. All patients included were females. There was a statistically significant difference in the mean VHI-10 and VAS scores between the FMS group and the control group (6.10 ± 7.20 vs 1.65 ± 1.30, P < 0.001, and 2.00 ± 1.69 vs 1.18 ± 0.393, P = 0.004, respectively). There was a statistically significant difference in the mean PSQI score between the FMS group and controls (8.65 ± 4.02 vs 5.97 ± 4.10, P = 0.007), even after adjusting for confounding demographic variables (adjusted P = 0.033). There was also a mild positive association between VHI-10 and PSQI scores (adjusted coefficient = 0.340, adjusted P = 0.080). However, the correlation was no longer significant after adjusting for confounding variables (P = 0.080, adjusted coefficient = 0.340).</p><p><strong>Conclusion: </strong>Sleep and voice disorders are more common in patients with FMS in comparison to controls. The presence of an association, albeit mild, between sleep disturbance and self-perceived voice handicap underscores the need to screen for sleep disorders in FMS patients presenting with dysphonia.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117629","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":"Immune Checkpoint Inhibitors and Laryngological Outcomes in Patients with Non-Head and Neck Cancer.","authors":"Neil S Dogra, Robert T Sataloff","doi":"10.1016/j.jvoice.2026.09.031","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.031","url":null,"abstract":"<p><strong>Objectives: </strong>As immune checkpoint inhibitor (ICI) utilization increases in cancer treatment, immune-related adverse events continue to be recognized. Voice, swallowing, and oral dysfunction substantially impair quality of life and treatment tolerance in cancer patients, but the laryngological risks of ICI therapy remain unclear. We compared outcomes for these functions after ICI versus non-ICI antineoplastic therapies.</p><p><strong>Methods: </strong>Using the TriNetX research network, we identified adults with non-head and neck malignancies treated with ICIs versus non-ICI systemic antineoplastics. To isolate off-target adverse events from the effects of cancer and its treatment, both cohorts excluded prior head and neck malignancy, laryngectomy or pharyngectomy, and head and neck radiotherapy. Cohorts were matched 1:1 on demographics, malignancy subtype, autoimmune conditions, and pertinent comorbidities. Incident laryngeal diagnoses were assessed at 6 months, 1 year, and 5 years after treatment initiation using hazard ratios (HR) from Cox proportional hazards regressions.</p><p><strong>Results: </strong>After matching, 123,628 patients remained in each cohort with all covariates well balanced. ICI exposure showed significantly higher hazards of voice disturbance (6 months: HR 1.59, 95% CI 1.44-1.75; 1 year: 1.61, 1.48-1.74; 5 years: 1.43, 1.35-1.52), vocal fold paralysis (6 months: 1.31, 1.13-1.51; 1 year: 1.37, 1.21-1.54; 5 years: 1.44, 1.30-1.58), xerostomia (6 months: 2.52, 2.29-2.78; 1 year: 2.65, 2.45-2.87; 5 years: 2.33, 2.19-2.48), dysphagia (6 months: 1.35, 1.29-1.41; 1 year: 1.44, 1.38-1.49; 5 years: 1.47, 1.43-1.51), and oral mucositis (6 months: 1.25, 1.18-1.31; 1 year: 1.41, 1.34-1.47; 5 years: 1.52, 1.46-1.58). Laryngospasm was elevated significantly with ICI exposure at 5 years (HR 1.53, 95% CI 1.09-2.13). Acute and chronic laryngitis, laryngeal edema, and chronic pharyngitis did not differ significantly at any interval.</p><p><strong>Conclusions: </strong>ICI initiation was associated with elevated hazards of voice, oral, and swallowing dysfunction across acute and long-term intervals. These adverse effects warrant consideration in pretreatment counseling and goals-of-care discussions, and clinicians should evaluate new voice, oral, or swallowing complaints promptly throughout ICI treatment.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117623","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":"Authors' Response to Comment on \"Support in Singing: A Pilot Prospective Randomized Crossover Study of Osteopathy and Singing Technique in 15 Amateur Singers\".","authors":"Mathias Aaen, Julie Møller Bie, Mark Tempesta, Cathrine Sadolin","doi":"10.1016/j.jvoice.2026.08.045","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.045","url":null,"abstract":"","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117626","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":"LD-205: Development and Technical Validation of a Laryngeal Dystonia-Oriented Whole-Brain ROI Atlas for Functional MRI Analysis.","authors":"Yuanjia Hu, Fangfang Xu, Lu Xing, Yujie Feng, Kaiyi Rong, Jia Song, Sennian Zheng, Shuyi Zeng, Yingshan Tan, Qiutong Chen, Peiyun Zhuang","doi":"10.1016/j.jvoice.2026.09.032","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.032","url":null,"abstract":"<p><strong>Objectives: </strong>Laryngeal dystonia (LD) is a voice motor disorder involving multilevel central networks. Existing LD functional magnetic resonance imaging (fMRI) studies use heterogeneous region-of-interest (ROI) definitions and parcellation schemes, limiting comparability and reproducibility. To provide a more consistent framework for ROI definition and whole-brain network-level analysis, we aimed to develop and technically validate a standardized, small-structure-preserving whole-brain ROI atlas for LD fMRI research.</p><p><strong>Methods: </strong>We integrated Automated Anatomical Labeling version 1 (AAL1)-derived cerebral and selected subcortical regions, the Spatially Unbiased Infratentorial Template (SUIT) cerebellar atlas, the Najdenovska thalamic nuclei atlas, and Brainstem Navigator-derived diencephalic and brainstem regions. Atlases were harmonized to Montreal Neurological Institute (MNI) space with nearest-neighbor interpolation and small-structure-prioritized merging, generating a 1-mm reference atlas (LD-208) and a 2-mm fMRI-ready atlas (LD-205). Quality control included ROI continuity, zero-voxel checks, voxel counts, connected components, and source tracing. LD-205 was tested in resting-state fMRI data from 10 healthy participants.</p><p><strong>Results: </strong>LD-208 and LD-205 contained 208 and 205 ROIs, respectively. Compared with LD-208, LD-205 did not retain three extremely small brainstem ROIs on the 2-mm grid. Both atlases had continuous ROI numbering and no zero-voxel ROIs. All LD-205 ROIs yielded valid voxels, mean blood oxygen level-dependent (BOLD) time series, and complete 205 × 205 connectivity matrices in every participant.</p><p><strong>Conclusions: </strong>LD-208 and LD-205 provide traceable and quality-controlled whole-brain ROI frameworks for LD-oriented fMRI research. The technical validation demonstrates the feasibility of applying LD-205 to conventional resting-state fMRI data and supports its use as a standardized ROI framework for future disease-specific studies.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117672","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":"Association Between Anterior Laryngeal Microweb and Vocal Fold Nodules: A Case-Control Study.","authors":"Claudia Esper Zamar, Sergio A Terrasa, Jorgelina Pachamé, Iris Rodríguez, Federico Sala","doi":"10.1016/j.jvoice.2026.09.017","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.017","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine whether congenital anterior laryngeal microweb is associated with vocal fold nodules (VFN), and to assess its prevalence in patients diagnosed with VFN and the coexistence of multiple minor structural alterations of the vocal cords (MSAs) as described by Paulo Pontes.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted in patients evaluated between 2012 and 2024. A total of 99 patients with VFN were included in the case group. A total of 649 were included in the control group, described as patients without VFN. Odds ratios (OR) and 95% confidence intervals (CI) were calculated.</p><p><strong>Results: </strong>The prevalence of microweb was 16% (16/99) in cases and 5% (36/649) in controls. After adjusting for sex, age at diagnosis, smoking status, coexistence of other minor laryngeal alterations, asthma, rhinitis, gastroesophageal reflux, and professional voice use, an association was observed (OR 4.14; 95% CI 1.82-9.39) between a history of laryngeal microweb and the development of VFN. Among the 96 patients with MSAs, 11 (11%) presented more than one alteration.</p><p><strong>Conclusion: </strong>This is the first study to attempt to control for potential confounding through a case-control design, confirming the association between anterior laryngeal microweb and VFN.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117702","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 Hyoid Movement On Vocal Fold And False Vocal Fold Configurations In Excised Human Larynges.","authors":"Zhaoyan Zhang, Lilliana Wang, Sarah Lehoux","doi":"10.1016/j.jvoice.2026.09.012","DOIUrl":"10.1016/j.jvoice.2026.09.012","url":null,"abstract":"<p><strong>Objectives: </strong>While it is generally understood that extrinsic muscle activation may change larynx position and orientation, its effect on vocal fold configuration, particularly the medial surface shape, remains largely unknown. In this study, the effects of hyoid bone movement on the true and false vocal fold configurations were investigated in excised human larynges.</p><p><strong>Method: </strong>For each larynx, a window was opened on one thyroid lamina to provide a medial view of the true vocal fold and false vocal fold. The larynx was mounted vertically with the cricoid cartilage fixed. The hyoid bone position was systematically modified along both the superior and anterior-posterior directions. The three-dimensional shape of the vocal fold medial surface and false vocal fold was reconstructed at different hyoid positions.</p><p><strong>Results: </strong>Upward hyoid movement lifted the false vocal fold, increasing both the vertical width and depth of the ventricle. Upward hyoid movement also decreased vocal fold length and tilted the vocal fold upward and backward (except for anterior-superior hyoid movement), and increased glottal width (except for posterior-superior hyoid movement). The effect of upward hyoid movement on vocal fold vertical thickness was insignificant and larynx-specific.</p><p><strong>Conclusions: </strong>These results suggest that extralaryngeal manipulations have more consistent effects on vocal fold length and tilting than the shape of the vocal fold medial surface, which appears to be largely controlled by intrinsic laryngeal muscles.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Related Differences in Acoustic Voice Quality and Mandarin Lexical-Tone Production Among Mandarin-Speaking Women.","authors":"Hager Ahmed Abdelsattar, Sumbul A Khan","doi":"10.1016/j.jvoice.2026.09.027","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.027","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether there are age differences in acoustic voice quality, Mandarin lexical-tone production, and within-speaker tone stability in Mandarin-speaking healthy women.</p><p><strong>Methods: </strong>A total of 220 women aged 18-84 years participated in a cross-sectional study and completed sustained vowel, maximum phonation time, connected speech, and Mandarin lexical-tone tasks. Smoothed cepstral peak prominence (CPPS), F0, jitter, shimmer, harmonics-to-noise ratio, corrected spectral voice-source measures, speech timing, AVQIv3-M, and time-normalized F0 contours for Tones 1-4 were analyzed. The contour root-mean-square error was used to quantify the tone stability. Generalized additive models and mixed-effects models were used to explore the age effects.</p><p><strong>Results: </strong>As age increased, CPPS, F0, harmonics-to-noise ratio, F0 range, speech rate, and maximum phonation time decreased, while jitter, shimmer, AVQIv3-M, corrected spectral measures, and CAPE-V ratings increased. The overall contour patterns of the four tones remained the same, but there were some differences in duration, excursion, and timing of these tones. Tone 3 exhibited the greatest contour variations, such as a delayed turning point and fewer measurable final rises. After adjustment for covariates, contour RMSE was positively related to age and negatively related to passage CPPS.</p><p><strong>Conclusions: </strong>In healthy aging, Mandarin-speaking women show changes both in the overall phonological quality and lexical-tone precision. The fusion of voice and tone-contour measures could help better assess Mandarin speech at the age level.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117635","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":"Respiratory Pressure and Sustained Performance Across Etiologic Categories of Voice Disorders: A Pilot Study.","authors":"Narihiro Kodama, Hiroki Sato, Katsuya Nakamura, Kiyohito Hosokawa","doi":"10.1016/j.jvoice.2026.09.022","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.022","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether a data-driven composite factor reflecting respiratory pressure-generating capacity and sustained pressure performance differs across etiologic categories of voice disorders and to examine its associations with maximum phonation time (MPT) and cepstral measures of phonatory stability.</p><p><strong>Study design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>Forty-three patients with voice disorders underwent voice and respiratory function assessments. Respiratory variables, including percent vital capacity (%VC), forced expiratory volume in one second to forced vital capacity ratio (FEV₁/FVC), maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax), and inspiratory and expiratory Mean Sustained Pressure Index (MSPI), were analyzed using principal component analysis (PCA) to derive a Respiratory Muscle Performance Factor (RMPF), a composite factor reflecting maximal pressure-generating capacity and sustained pressure performance. Differences in RMPF across etiologic categories (organic, neurological, and functional voice disorders) were examined using analysis of covariance (ANCOVA) controlling for age and sex. Associations between RMPF and phonatory measures, including MPT and cepstral peak prominence (CPP) derived from sustained vowels and connected speech, were analyzed using Spearman's rank correlation coefficients within each etiologic category.</p><p><strong>Results: </strong>RMPF differed significantly across diagnostic categories (P = 0.004), with the organic voice disorder group demonstrating significantly higher values than the functional voice disorder group. No significant effects of age or sex were observed. In the organic and neurological voice disorder groups, RMPF showed significant positive correlations with MPT. In contrast, in the functional voice disorder group, RMPF showed a significant positive correlation with CPP derived from the connected-speech sentence \"waɾanojanenoieda.\" No significant associations were observed between RMPF and the remaining cepstral measures.</p><p><strong>Conclusions: </strong>Respiratory muscle performance differs across etiologic categories of voice disorders and demonstrates diagnosis-specific associations with phonatory measures. Functional voice disorders were characterized by an association between respiratory function and connected-speech phonatory stability, whereas organic and neurological voice disorders demonstrated associations with phonatory duration. These findings suggest that disease-specific respiratory-phonatory interactions may contribute to differences in voice production and phonatory performance across voice disorder populations.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076474","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}