Journal of Voice最新文献

{"title":"Epidemiological and Surgical Outcomes of 321 Pediatric Subglottic Stenoses: A Retrospective Study.","authors":"Aliya Turayeva, Gulmira Mukhamadiyeva, Almat Bekpan, Tolga Kandogan, Nataliya Papulova, Kalamkas Sagandykova, Jerome R Lechien","doi":"10.1016/j.jvoice.2026.09.030","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.030","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate epidemiological, etiological, and surgical outcomes of pediatric subglottic stenosis (PSS).</p><p><strong>Methods: </strong>Medical records of 321 children with PSS, identified through the national multicenter database of the Republic of Kazakhstan (data centralized at the Salidat Kairbekova National Scientific Center for Health Development, Astana) and treated at institutions across all regions of the country from 2019 to 2024, were retrieved for demographic, etiological, and surgical outcomes.</p><p><strong>Results: </strong>Of the 520 identified PLS patients, 321 had PSS (133 females). The female/male ratio progressively shifted to a predominance of males from 2019 to 2024. The mean age of diagnosed patients was 4.38 years. Most PSS cases were Myer-Cotton grades I and II. A total of 383 surgical procedures were carried out in the 321 patients (1.2 procedures per patient), primarily consisting of balloon dilatation with transoral CO2 laser tissue excision (n = 191), transoral cold instrument tissue resection (n = 89), and transoral CO2 laser tissue excision without balloon dilatation (n = 64). Of the 39 tracheostomized patients, 14 (35.9%) were adequately decannulated postoperatively, with 61 patients being decannulated immediately after the first procedure. The mean hospital stay was 9.0 ± 4.0 days.</p><p><strong>Conclusions: </strong>Grade-tailored surgical approaches for PSS achieved favorable decannulation rates, with transoral procedures being effective for lower-grade stenoses in pediatric patients.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139054","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":"An Acoustic Exploration of Female Voice Under Loading in Beijing's Winter Environment.","authors":"AnTong Liu, HaKyung Kim, XiaoMing Liu, ShuHuan An, XiaoShan Ying, MeiNi Zhou, MuFeng Xu","doi":"10.1016/j.jvoice.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.006","url":null,"abstract":"<p><strong>Objectives: </strong>This exploratory study examined whether female university students with different residence durations in Beijing differed in subjective voice symptoms, baseline acoustic characteristics, and acoustic responses to a laryngeal diadochokinesis vocal loading task (LDDK-VLT) in winter.</p><p><strong>Methods: </strong>Forty-one nonsmoking female undergraduate students aged 18-21 years were recruited at Beijing Language and Culture University and divided into recent arrivals (n = 16), intermediate residents (n = 14), and local controls (n = 11). Acoustic recordings were obtained at baseline (t0), immediately after the LDDK-VLT (t1), and after a 15-minute quiet rest (t2). Measures included Maximum Phonation Time (MPT), Dysphonia Severity Index (DSI), Fundamental Frequency (F0), Intensity, Jitter, Shimmer, Harmonics-to-Noise Ratio (HNR), and Smoothed Cepstral Peak Prominence (CPPS). Participants completed the Voice Handicap Index-10 (VHI-10) and Vocal Fatigue Index (VFI) after all recordings. Group differences, acoustic change scores, questionnaire-acoustic associations, and longitudinal acoustic trajectories were analyzed.</p><p><strong>Results: </strong>Recent arrivals showed numerically higher VHI-10 and VFI Factor 1 scores than local controls, but no questionnaire or baseline acoustic measure differed significantly across groups after false discovery rate (FDR) correction. Change-score analyses showed an uncorrected group difference for post-rest Jitter (free speech) change, but this did not survive FDR correction. Linear mixed-effects models showed significant corrected time effects for MPT, DSI, Intensity (reading), Intensity (free speech), Shimmer (reading), CPPS (reading), and CPPS (free speech). No group main effect or Group × Time interaction remained significant after correction. Questionnaire-acoustic associations were exploratory and did not survive correction.</p><p><strong>Conclusions: </strong>The LDDK-VLT elicited measurable time-dependent acoustic changes, whereas residence duration in Beijing did not significantly moderate longitudinal acoustic trajectories after correction. Descriptive patterns in subjective scores and selected acoustic changes suggest that residence duration may be relevant to voice status and recovery, but larger studies with direct environmental exposure assessment are needed.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026599","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":"Botulinum Toxin B for Laryngeal Dystonia: A Scoping Review.","authors":"Brendan Douglas McNeely, Ying Jie Li, Amanda Hu","doi":"10.1016/j.jvoice.2026.09.029","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.029","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to comprehensively map the available literature on botulinum toxin B (BoNT-B) for the treatment of laryngeal dystonia.</p><p><strong>Data sources: </strong>A comprehensive librarian-designed strategy was used to search EMBASE, MEDLINE, and Web of Science for English-language studies from database inception to December 2025.</p><p><strong>Review methods: </strong>A PRISMA-ScR scoping review was registered on Open Science Framework (10.23041/OSF.IJ/R3BG4). Study selection was independently performed by two investigators for all English-language studies of adult patients investigating BoNT-B treatment for laryngeal dystonia. BoNT-B treatment dosing, treatment outcomes (ie, voice breaks/volume, spasms), patient-reported outcomes measures (PROMs), and adverse treatment events (ie, breathiness/dyspnea, dysphagia) were analyzed. Risk of bias was assessed with the ROBINS-I V2 tool.</p><p><strong>Results: </strong>In total, 188 studies were identified through the database searches, of which four studies met the inclusion criteria following full manuscript review. Two studies were clinical cohort studies in nature, and two were case reports. The total number of participants included in all studies was 47, of which 46 were diagnosed with adductor laryngeal dystonia. Injection dosing regimen ranged from 50-750 units among the included studies. Botulinum toxin treatment outcome reporting was largely subjective but demonstrated efficacy of BoNT-B injection. No study evaluated standardized PROMs in BoNT-B treatment of laryngeal dystonia. No serious adverse events were described among all included studies. Risk of bias was scored as \"Serious\" for all included studies.</p><p><strong>Conclusion: </strong>The current study identified a gap within the literature recommending objective clinical evaluation of BoNT-B for the treatment of laryngeal dystonia.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139060","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":"Automated Tessituragram Analysis Software of Musical Instrument Digital Interface (MIDI) Files to Quantitatively Assess Musical Demands.","authors":"Troy O Conklin, Paul M Patinka","doi":"10.1016/j.jvoice.2026.09.025","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.025","url":null,"abstract":"<p><strong>Objectives: </strong>Quantitatively assessing musical demands primarily relies on time-consuming manual data entry methods. This reliance limits the development of the larger datasets needed to assess generalizable trends in musical compositions. To remedy this labor-intensive manual data entry issue, the purpose of this study was to: DESIGN: A Python application was developed to parse and convert single-track MIDI files into a list of pitch frequencies and silences. The software then uses this list to compute musical difficulty metrics based on previously established tessituragram analysis methods. After parsing a .midi or .mid file, the software outputs the total performance time, time dose, rest time, cycle dose, total range, interquartile tessitura range, and the percent of time spent in generalized musical passaggi as a user-friendly graphic with numeric depictions or as a numeric table. The software was tested using MIDI files generated from the transcribed melodic lines of 150 manually assessed operatic arias.</p><p><strong>Results: </strong>Comparing software outputs against the manual analysis of the 150 arias reveals a 98.7% aggregate match, indicating that the software is accurate. Differences between software and manual measurements are likely attributable to input errors during human data entry and the software's ability to parse the data more finely.</p><p><strong>Conclusions: </strong>The software developed in this research quantitatively analyzes single-track MIDI files and outputs various metrics of musical demands. Outputs from the software align with the results of previously published research using manual data entry methods. Future scholarship will utilize this software to generate larger datasets and assess generalizable trends in musical compositions.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129041","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":"Are Voice Symptoms Being Normalized as \"Occupational Costs\"? Methodological Considerations and Clinical Insights from a Knowledge, Attitudes, and Practices Survey.","authors":"Fei-Yi Zhao, Qiang-Qiang Fu, Sisi Luo","doi":"10.1016/j.jvoice.2026.09.003","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.003","url":null,"abstract":"","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002804","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":"Therapy Dogs During In-Office Laryngologic Procedures: A Pilot Study.","authors":"Nawfal Saleem, Natalie Weiss, Andrew Franklin, Katerina Green, Amy Rutt","doi":"10.1016/j.jvoice.2026.08.048","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.048","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between interaction with a certified therapy dog prior to awake, in-office laryngologic procedures and patient-reported anxiety, depression, and pain compared with standard care.</p><p><strong>Methods: </strong>This was a prospective pilot study of adult patients undergoing in-office laryngologic procedures. Participants completed pre- and post- assessments of anxiety, depression, and pain. Patients who were seen with certified therapy dogs comprised the canine group and were compared with a control group of patients who were not seen with therapy dogs. Group differences were assessed using independent-samples t tests or Mann-Whitney U tests for nonparametric data. Within-group changes were analyzed with paired t tests or Wilcoxon signed-rank tests. Group × time interactions were assessed using mixed two-way ANOVA.</p><p><strong>Results: </strong>Fifty patients were included (31 canine, 19 control). Baseline demographics were similar between groups. In the canine cohort, anxiety and depression decreased significantly following the procedure, while pain showed a nonsignificant reduction. In the control group, anxiety decreased significantly, but pain and depression did not change significantly. Post-procedure pain and depression were significantly lower in the canine group compared with controls. \"Significant group × time interactions were observed for anxiety, pain, and depression.\"</p><p><strong>Conclusion: </strong>Patients who interacted with therapy dogs was associated with lower patient-reported anxiety and depression, supporting the use of therapy dog programs to improve patient experience during in-office procedures. These findings support further investigation of animal-assisted interventions using randomized study designs and validated outcome measures.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009329","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":"Performance of In-Office Laryngeal Procedures Using Single-Use Endoscopes.","authors":"Hannah L Kenny, Bryan Renslo, Emily A Garvey, Kathleen M Tibbetts","doi":"10.1016/j.jvoice.2026.09.009","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.009","url":null,"abstract":"<p><strong>Objectives: </strong>In-office laryngeal procedures have expanded in recent years due to several factors, including advances in equipment and efforts to reduce health care costs. Single use endoscopes have been adopted primarily in the inpatient setting and offer several advantages over reusable equipment, including lower capital investment and the elimination of costs of reprocessing and repairs. This study investigates the performance of single use endoscopes for in-office laryngeal procedures.</p><p><strong>Methods: </strong>A retrospective review at a single institution of patients who underwent in-office laryngeal procedures using single-use channeled endoscopes. Data including demographics, pathology, equipment, treatment outcomes, and adverse events were collected retrospectively.</p><p><strong>Results: </strong>Twenty-four patients who underwent in-office blue light laser or biopsy procedures between 10/2023 and 4/2024 were included. Among seven completed biopsies, six specimens (85.7%) were adequate for diagnosis; there were no complications. Twenty-one laser procedures were performed, with 20 successfully completed. One patient had poor tolerance requiring early termination. There were 2 minor post-procedural adverse effects (11.1%), including dyspnea and headache. Pathologies treated included laryngeal papilloma (44.4%), vocal fold polyps (27.8%), dysplasia (16.7%), redundant arytenoid/postcricoid mucosa (11.1%), vascular ectasias (16.7%), and hyperkeratosis (5.56%). Laser output ranged from 9 to 289 Joules. Ten patients had resolution of lesion(s) (55.6%), 4 had reduction in disease burden (22.2%), 2 had stable disease (11.1%), and 1 had disease progression (5.56%). One patient was lost to follow-up.</p><p><strong>Conclusion: </strong>In-office laryngeal procedures using single-use endoscopes are feasible, with acceptable outcomes which align with standard of care. This treatment modality may improve access to centers where reusable equipment is not available, and may improve efficiency in the treatment of laryngeal disorders.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009278","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":"Trends in Medicare Part B Fee-for-Service Billing of Diagnostic Flexible Laryngoscopy and Videolaryngostroboscopy by Provider Type, 2015-2023.","authors":"Chulwoo J Kim, Megalan S Tso, David Z Allen, Merry E Sebelik","doi":"10.1016/j.jvoice.2026.08.041","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.041","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate national trends and 2023 state-level variation in diagnostic flexible laryngoscopy (DFL) and videolaryngostroboscopy (VLS) utilization by physicians and advanced practice providers (APPs).</p><p><strong>Methods: </strong>This is a repeated cross-sectional analysis of Medicare Part B fee-for-service data from 2015 to 2023, collected in the annual Medicare Provider Utilization and Payment Data: Physician and Other Practitioners Public Use Files and the Medicare Monthly Enrollment data published by the Centers for Medicare and Medicaid Services. Compound annual growth rates (CAGR) and linear and log-linear regression models were calculated to assess trends in APP and otolaryngologist annual DFL, VLS, and combined DFL and VLS volume per 10,000 beneficiaries.</p><p><strong>Results: </strong>Log-linear analysis indicated no significant change in national annual combined DFL and VLS density (P = 0.786). Conversely, log-linear analysis indicated significant increases in national annual VLS density (P < 0.001) with an increase from 19.7 per 10,000 beneficiaries in 2015 to 29.6 in 2023 (CAGR +5.2%). From 2015 to 2023, APP annual combined DFL and VLS density increased (CAGR +17.2%), while the log-linear model estimates approximately 16.0% growth per year (P < 0.001). Meanwhile, otolaryngologist combined DFL and VLS density did not significantly change (P = 0.085). By 2023, APPs contributed over 20% of the annual combined DFL and VLS density in seven states.</p><p><strong>Conclusions: </strong>While otolaryngologists remain the primary providers of DFL and VLS, APP national annual DFL, VLS, and combined DFL and VLS density is rapidly growing. Insignificant changes in otolaryngologist national annual combined DFL and VLS density suggest stable utilization by otolaryngologists despite rapid growth associated with APPs. The significant growth in national annual VLS utilization suggests increasing adoption of VLS. These findings suggest evolving procedure choices and rapid growth for APPs within otolaryngology, prompting further study of procedural training and outcomes across provider types.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002820","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":"Validation of FUDAN VOICE: Signal and Acoustic Feature Comparison with Computerized Speech Lab (CSL).","authors":"Siyan Xu, Xia Hu, Rui Fang, Chen Chen, Jun Shao, Chunsheng Wei, Min Shu","doi":"10.1016/j.jvoice.2026.08.047","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.047","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to validate the consistency between audio acquired by a custom WeChat mini-program, FUDAN VOICE (named Voice Acquisition in our earlier study), and Computerized Speech Lab (CSL) recordings at both signal and acoustic feature levels, and to characterize aggregate signal deviations between the two recording pathways, encompassing contributions from hardware, platform-level processing, and environmental noise.</p><p><strong>Methods: </strong>A simultaneous recording design was employed, capturing parallel audio from CSL and FUDAN VOICE across a soundproof room and a quiet office environment. Signal-level agreement was assessed using the root mean square error (RMSE), Pearson correlation coefficient (Pearson's rho), and mean coherence. Acoustic features such as fundamental frequency (F0), jitter, shimmer, noise-to-harmonic ratio (NHR), cepstral peak prominence (CPP), and cepstral/spectral index of dysphonia (CSID) were extracted and compared for correlation analysis and intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>Signal-domain analysis revealed favorable agreement between FUDAN VOICE and CSL, with low RMSE and preserved spectral structure below 5 kHz, although high-frequency attenuation (> 5 kHz) was observed. Feature-level verification demonstrated excellent concordance for F0 mean, CPP, and CSID (r > 0.82, ICC > 0.82) across environments, whereas F0 extreme values-particularly F0 min-showed marked degradation in non-soundproof settings. Jitter and NHR remained robust, while shimmer exhibited environmental sensitivity.</p><p><strong>Conclusions: </strong>FUDAN VOICE achieves reliable remote acoustic acquisition for F0 mean, CPP, and CSID across soundproof and office environments, though high-frequency attenuation (> 5 kHz) and noisy-setting F0 degradation warrant caution. This study establishes the first validation framework for super-app-based voice acquisition, supporting the standardization of WeChat mini-programs in mobile health.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002827","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":"Timing of Laryngeal Surgery in Gender Affirming Care: A Single Institution Review.","authors":"Michael R Xiang, Randy Bach, Natasha Mirza","doi":"10.1016/j.jvoice.2026.08.020","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.020","url":null,"abstract":"<p><strong>Objectives: </strong>To understand where laryngeal surgery falls in the order of gender-affirming surgeries (GAS) for transgender and gender diverse (TGD) patients, by analyzing: (1) number and types of GAS pursued, (2) chronological order of GAS pursued, and (3) whether the timing of laryngeal surgery impacts functional voice outcomes METHODS: Retrospective chart review of adult patients undergoing laryngeal surgery within a single institution's Otolaryngology department for a primary diagnosis of \"Gender Dysphoria.\" TGD patients pursuing voice therapy (VT) only were enlisted as controls. Charts were reviewed for all GAS performed and voice-related questionnaires (VHI-10 and TWVQ).</p><p><strong>Results: </strong>Seventy-two patients status post laryngeal surgery with an average (standard deviation [SD]) age of 35 (13) years; 62 underwent vocal feminization, and 10 underwent vocal masculinization. On average (SD), patients underwent 2.61 (1.52) GAS, consisting of 1.42 (0.64) laryngeal surgeries, 0.34 (0.70) facial surgeries, 0.43 (0.58) top surgeries, and 0.44 (0.58) bottom surgeries. Twenty-nine pursued laryngeal surgery only. Among the 43 who underwent multiple GAS, seven pursued laryngeal surgery first, seven pursued laryngeal surgery between other GAS, and 29 pursued laryngeal surgery last (P < 0.0001). Patients who pursued laryngeal surgery first had higher preoperative TWVQ scores (P = 0.018). No significant differences in postoperative or delta TWVQ scores by timing of laryngeal surgery were observed. Forty-six patients status post VT were enrolled as controls, consisting of 40 transfeminine and six transmasculine patients. Significant differences were identified in post-intervention (P = 0.0007) and delta (P = 0.0074) TWVQ scores between surgery and VT cohorts.</p><p><strong>Conclusion: </strong>Laryngeal surgery is highly effective in treating vocal incongruence. Most patients pursue laryngeal surgery last. However, timing of laryngeal surgery does not affect voice outcomes. There is a need to increase awareness of voice surgery as an effective option for gender dysphoria, especially considering the many barriers to laryngeal surgery (insurance limitations, scarcity of specialized surgeons, geographic disparities, etc).</p><p><strong>Level of evidence: </strong>Retrospective cohort study, single institution chart review.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002833","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}