Journal of Voice最新文献

{"title":"Perception of Femininity and Masculinity in Voices as Rated by Transgender and Gender Diverse People, Professional Speech and Language Pathologists, and Cisgender Naive Listeners.","authors":"Jenny Holmberg, Maria Södersten, Ida Linander, Fredrik Nylén","doi":"10.1016/j.jvoice.2024.07.034","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.034","url":null,"abstract":"<p><strong>Objective: </strong>To explore whether cisgender naive listeners, transgender and gender diverse (TGD) listeners, and speech-language pathologists (SLPs) experienced in providing gender-affirming voice training differ in their perception of femininity and masculinity in voices.</p><p><strong>Methods: </strong>Samples of spontaneous speech were collected from 95 cisgender, and 37 TGD speakers. Three listener groups of cisgender naive (N = 77), TGD (N = 30), and SLP (N = 14) listeners, respectively, rated the voices on visual analog scales in two randomly ordered blocks, in which the perceived degree of femininity was rated separately from the perceived degree of masculinity.</p><p><strong>Results: </strong>The three listener groups showed similar patterns in their distribution of ratings on the femininity and masculinity scales. The TGD listeners' mean ratings did not differ from the cisgender naive listeners', whereas SLPs showed a small, but significant, difference in their ratings compared with both TGD and cisgender naive listeners and rated the voices lower on both the femininity and masculinity scales.</p><p><strong>Conclusion: </strong>The results differ from previous studies as TGD, and cisgender naive listeners rated the voices very similarly. The lower ratings of femininity and masculinity by the SLPs were likely influenced by their awareness of the complexity in the perception of voices. Therefore, SLPs providing gender-affirming voice training should be attentive to how their professional training may influence their perception of femininity and masculinity in voices and encourage discussions and explorations of the TGD voice client's perceptions of voices.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047388","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":"A Meta-Analytic Reliability Generalization Study of the Pediatric Voice Handicap Index.","authors":"Nuri Doğan, Mehmet Taha Eser, Damlasu Yağcıoğlu, Fatma Esen Aydınlı","doi":"10.1016/j.jvoice.2024.07.013","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.013","url":null,"abstract":"<p><strong>Objectives: </strong>The pediatric voice handicap index (pVHI) is a widely used proxy-reported outcome measure. However, its reliability values are subject to variability across studies. Accordingly, the objective of this study is to analyze the mean reliability estimation and stratified alpha coefficient of the pVHI. Another aim of the study is to determine if differences in reliability values can be linked to the specific research characteristics.</p><p><strong>Study design: </strong>This is a meta-analytic reliability generalization study.</p><p><strong>Methods: </strong>Two researchers used Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to review five databases (Scopus, Web of Science, YÖKTEZ, Ulakbim, and PUBMED) for publications published between 2007 and 2022 that used pVHI. A meta-analysis was then conducted on 12 papers that fit the predetermined inclusion criteria to ascertain the total effect size of the Cronbach's alpha coefficient of pVHI scores. The reliability coefficients of pVHI were computed utilizing Cochran Q, I², and the lower and upper bounds of mean reliability. Additionally, moderator analyses were employed to examine the heterogeneity among studies.</p><p><strong>Results: </strong>The computed mean reliability value was approximately 0.916 [0.8840, 0.9401] which is within the acceptable range (>0.70). Furthermore, the mean stratified Cronbach's alpha coefficient was found to be roughly 0.95. The heterogeneity statistics indicated that the reliability estimations for each study varied significantly (Q ∼ (df = 11) ∼ = 163.6172, P < 0.0001; I² = 93.90%).</p><p><strong>Conclusions: </strong>Results indicate that pVHI yields sufficiently reliable outcomes. Furthermore, the reliability of the pVHI remained consistent regardless of index language, participant group (healthy, dysphonic, or both), or continent of origin. These results improve the clinical value and utility of pVHI by providing further evidence of its reliability.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047387","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":"Transoral Endoscopic Excision of Laryngeal Schwannoma.","authors":"Xi Wang, Xingming Chen, Yanyan Niu, Hong Huo, Xiaoli Zhu","doi":"10.1016/j.jvoice.2024.07.036","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.036","url":null,"abstract":"<p><strong>Objective: </strong>Schwannomas originating within the larynx are rare and there is no clear consensus on the diagnostic workup or treatment. This study aims to explore the clinical features of laryngeal schwannoma and evaluate the surgical method of transoral endoscopic excision, especially with coblation.</p><p><strong>Methods: </strong>Data from patients diagnosed with laryngeal schwannoma who underwent surgery at Peking Union Medical College Hospital from 2017 to 2022 were retrospectively analyzed. All cases were evaluated with a flexible laryngoscope and computed tomography and/or magnetic resonance imaging before surgery.</p><p><strong>Results: </strong>Four patients, comprising one male and three females aged 19 to 61years, were included. All patients presented with persistent and progressive hoarseness, and two also experienced dyspnea on exertion. One patient was a recurrent case who underwent transoral tumor resection with a laser, while another patient had received a transoral incisional biopsy before visiting our hospital. Transoral excision was performed in each case. One tumor was excised using microlaryngeal instruments under a microscope, and the other three with coblation assisted by an operating laryngoscope. All laryngeal schwannomas were removed in a single block. All patients were successfully extubated following surgery, recovered without complications, and showed no evidence of recurrence.</p><p><strong>Conclusion: </strong>Transoral surgery better preserves laryngeal function, reduces complications, and shortens hospital stays. Transoral endoscopic excision, particularly when performed with coblation, is highly recommended for its excellent visualization and ability to completely excise the tumor. This method is a safe and effective approach, especially for large laryngeal schwannomas in hard-to-reach locations.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037571","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":"Varying Supraglottic Pressure Using Controlled Supraglottic Pressure Phonation with a Straw-Shaped Mouthpiece in Healthy Subjects.","authors":"Katerina A Smereka, Adriana M Nickels, Owen P Wischhoff, Matthew A Silverman, Jack J Jiang","doi":"10.1016/j.jvoice.2024.07.029","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.029","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to expand on a novel method for semioccluded vocal tract therapy (SOVT) called controlled supraglottic pressure phonation, and investigate the mechanism that introduced supraglottic pressure mediates a decrease in impedance during SOVT therapy. Instead of the previously used CPAP mask, this study analyzes controlled supraglottic pressure phonation by use of a straw mouthpiece to deliver supraglottic pressure.</p><p><strong>Methods: </strong>Twenty-six human subjects were randomly assigned to one of four supraglottic pressure levels: 0, 2, 4, and 6 cm H₂O, which were controlled through a continuous positive airway pressure device. Subjects were asked to phonate during a SOVT task for one round (referred to as the \"short-duration\" task) and eight rounds (referred to as the \"long-duration\" task), in which acoustic and aerodynamic properties were measured before and after. Subjects were surveyed for the levels of discomfort experienced during controlled supraglottic pressure phonation therapy and subjective levels of improvement of vocal economy.</p><p><strong>Results: </strong>Significant differences were observed between pre- and post-task measurement for phonation threshold pressure for the long-duration task for the 2 cmH₂O group. Frequency measurement was not found to have statistically significant differences. The perceived phonatory effort was not significantly different at any pressure levels.</p><p><strong>Conclusions: </strong>Lower supraglottic pressure levels will improve ease of phonation for longer durations, however, shorter-duration tasks will not be effective. Controlled supraglottic pressure phonation coupled with straw phonation may produce an improved vocal economy for those who have access to an oppositional airflow setup.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996826","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":"Effect of Vocalization on Human Aerosol Dynamics: Whispering Produces More Aerosols than Speaking.","authors":"Enni Sanmark, Anna Tuhkuri-Matvejeff, Ahmed Geneid, Lotta-Maria Oksanen, Paavo Alku, Jani Hakala, Paavo Heikkilä, Ville Silvonen, Aimo Taipale, Topi Rönkkö, Anne-Maria Laukkanen, Sampo Saari, Ville A Vartiainen","doi":"10.1016/j.jvoice.2024.07.028","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.028","url":null,"abstract":"<p><strong>Objectives: </strong>Sound pressure and exhaled flow have been identified as important factors associated with higher particle emissions. The aim of this study was to assess how different vocalizations affect the particle generation independently from other factors.</p><p><strong>Design: </strong>Experimental study.</p><p><strong>Methods: </strong>Thirty-three experienced singers repeated two different sentences in normal loudness and whispering. The first sentence consisted mainly of consonants like /k/ and /t/ as well as open vowels, while the second sentence also included the /s/ sound and contained primarily closed vowels. The particle emission was measured using condensation particle counter (CPC, 3775 TSI Inc.) and aerodynamic particle sizer (APS, 3321 TSI Inc.). The CPC measured particle number concentration for particles larger than 4 nm and mainly reflects the number of particles smaller than 0.5 µm since these particles dominate total number concentration. The APS measured particle size distribution and number concentration in the size range of 0.5-10 µm and data were divided into >1 µm and <1 µm particle size ranges. Generalized linear mixed-effects models were constructed to assess the factors affecting particle generation.</p><p><strong>Results: </strong>Whispering produced more particles than speaking and sentence 1 produced more particles than sentence 2 while speaking. Sound pressure level had effect on particle production independently from vocalization. The effect of exhaled airflow was not statistically significant.</p><p><strong>Conclusions: </strong>Based on our results the type of vocalization has a significant effect on particle production independently from other factors such as sound pressure level.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Value of Narrow Band Imaging Endoscopy in the Early Diagnosis and Staging Assessment of Laryngeal and Hypopharyngeal Cancer.","authors":"Dapeng Wang, Ning Li, Ruyuan Guo, Jing Pang, Li Zhang, Fuli Zhang, Junjie Zhang, Xiaotang Yang","doi":"10.1016/j.jvoice.2024.07.002","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.002","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical value of narrow band imaging (NBI) endoscopy in the early diagnosis and staging assessment of laryngeal and hypopharyngeal cancer.</p><p><strong>Methods: </strong>A total of 78 patients with lesions in the hypopharynx or larynx were examined using endoscopy, observed under both white light and NBI modes, and graded using NBI. Using Lugol's iodine solution, laryngeal and hypopharyngeal lesions were graded using iodine staining. Using histopathological examination or postoperative pathological results as the diagnostic criteria, the sensitivity, specificity, and accuracy of endoscopy and iodine staining in diagnosing early cancer and precancerous lesions were evaluated.</p><p><strong>Results: </strong>Multiple lesions were identified by both methods, and pathological examination confirmed 86 lesions, including early squamous cell carcinoma and precancerous lesions, such as early esophageal cancer, high-grade esophageal intraepithelial neoplasia, and hypopharyngeal cancer. Endoscopy showed significantly higher accuracy, detection rate, sensitivity, and specificity in NBI mode than in white light mode (96.12%, 86.05%, 97.37%, 86.67% vs 86.05%, 76.74%, 86.84%, 80%, respectively; P < 0.05). NBI grading and iodine staining grading showed good consistency with pathological diagnosis, with a Kappa value of 0.684 and 0.622, respectively.</p><p><strong>Conclusions: </strong>NBI endoscopy allows for better observation of subtle structural changes on the surface of lesions compared to white light endoscopy. It provides high accuracy in detecting early laryngeal and hypopharyngeal cancer and precancerous lesions, determining biopsy sites, facilitating early diagnosis, and establishing safe surgical margins. NBI endoscopy offers a viable alternative for non-invasive screening and early diagnosis of laryngeal and hypopharyngeal cancer, showing great potential for clinical advancement.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989381","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":"Normative Values for the Children Voice Handicap Index-10 (CVHI-10) and for the Children Voice Handicap Index-10 for Parents (CVHI-10-P).","authors":"Vincenzo De Maio, Francesco Mozzanica, Arianna Cardella, Antonio Schindler, Thomas Murry, Andrea Ricci-Maccarini","doi":"10.1016/j.jvoice.2024.07.011","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.011","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to establish normative data and cut-off scores for the Children Voice Handicap Index-10 (CVHI-10) and the Children Voice Handicap Index-10 for Parents (CVHI-10-P) METHODS: For normative data, CVHI-10 and CVHI-10-P questionnaires originally developed in the Italian language were completed by 201 children without dysphonia and with no history of voice disorders, and by 1 of their parents. The results were analyzed for mean, standard deviation (SD), and standard error of the mean (SEM) for both questionnaires. For cut-off values determination, data from 49 dysphonic children and from 1 of their parents were also used. This analysis was based on the sensitivity and specificity indicators of the questionnaires using the \"receiver operating characteristic\" (ROC) curve.</p><p><strong>Results: </strong>Analysis of the questionnaires related to healthy children revealed a mean of 0.26 (SD 0.74; SEM 0.06) for CVHI-10 and a mean of 0.15 (SD 0.49; SEM 0.04) for CVHI-10-P for the normative values. ROC curve analysis allowed us to establish the cut-off scores of 2.5 for CVHI-10 and 1.5 for CVHI-10-P.</p><p><strong>Conclusions: </strong>This study offers normative data for CVHI-10 and CVHI-10-P and provides cut-off values for both questionnaires to distinguish healthy and pathologic responders.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983729","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":"Prospective Teacher's Voice Questionnaire (PTVQ): Development of a Questionnaire to Assess Training-Related Voice Symptoms Among Prospective Teachers.","authors":"Lady Catherine Cantor-Cutiva, Celina Malebrán, Iára Bittante de Oliveira, Felipe Cerda, Maria Del Carmen Dalmasso, Adriana Díaz, Carlos Manzano, Alejandro Morales, Léslie Piccolotto Ferreira, Jessica Ramonda, Maria Lúcia Vaz Masson","doi":"10.1016/j.jvoice.2024.07.027","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.027","url":null,"abstract":"<p><strong>Aim: </strong>To develop and validate a self-administered population-specific survey, available in Spanish, Portuguese, and English, which investigates the prevalence of voice symptoms and perceptions of risk factors associated with training among prospective teachers.</p><p><strong>Methods: </strong>The present study had three stages: the first stage included a literature review and content validation by experts that supported the survey development. From this phase, we defined five aspects of the Prospective Teacher's Voice Questionnaire (PTVQ): (1) target population, (2) research objectives, (3) questions to be included, (4) scales for the answers, and (5) relevance, comprehensiveness, clarityclarity, and understandability of the questions. This process was performed in parallel for the three languages (Spanish, Portuguese, and English). The second stage included pilot testing. This involved administering the first draft of the survey to a group of 120 students to evaluate the feasibility and effectiveness of the survey instrument, identify any potential problems with the survey, and refine the instrument based on feedback from the pilot participants. The third stage includes the restructuring of the questionnaire's voice quality section to eliminate redundant questions. Through Principal Component Analysis, multicollinear variables were condensed, facilitating the removal of redundant items, and ensuring that the final questionnaire comprised only the most relevant and discriminative questions.</p><p><strong>Results and discussion: </strong>The final version of the survey, available in Spanish, Portuguese, and English, consists of four sections with a total of 57 questions. The development of the PTVQ represents a significant step toward better understanding and addressing voice disorders among prospective teachers. Future research could further refine the questionnaire and explore its predictive validity in identifying individuals at risk of voice disorders early in their teaching careers. Additionally, interventions based on the findings from the PTVQ could be developed to support the voice health and well-being of prospective teachers, ultimately improving teaching quality and job satisfaction in educational settings.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983730","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":"Central Mechanisms and Pathophysiology of Laryngeal Dystonia: An Up-to-Date Review.","authors":"Chang Woo Lee, Marie T Krüger, Harith Akram, Ludvic Zrinzo, John Rubin, Martin A Birchall, Jonathan M Fishman","doi":"10.1016/j.jvoice.2024.07.007","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.007","url":null,"abstract":"<p><strong>Objective: </strong>Laryngeal dystonia (LD), previously termed spasmodic dysphonia, is an isolated focal dystonia that involves involuntary, uncontrolled contractions of the laryngeal muscles during speech. It is a severely disabling condition affecting patients' work and social lives through prevention of normal speech production. Our understanding of the pathophysiology of LD and available therapeutic options are currently limited. The aim of this short review is to provide an up-to-date summary of what is known about the central mechanisms and the pathophysiology of LD.</p><p><strong>Methods: </strong>A systematic review of the literature was performed searching Embase, CINHAL, Medline, and Cochrane with the cover period January 1990-October 2023 with a search strategy ((\"Laryngeal dystonia\" OR \"Spasmodic dysphonia\") AND (\"Central Mechanism\" OR \"Pathophysiology\")). Original studies involving LD patients that discussed central mechanisms and/or pathophysiology of LD were chosen.</p><p><strong>Results: </strong>Two hundred twenty-six articles were identified of which 27 articles were included to formulate this systematic review following the screening inclusion and exclusion criteria. LD is a central neurological disorder involving a multiregional altered neural network. Affected neural circuits not only involve the motor control circuit, but also the feedforward, and the feedback circuits of the normal speech production neural network, involving higher-order planning, somatosensory perception and integration regions of the brain.</p><p><strong>Conclusion: </strong>Speech production is a complex process, and LD is a central neurological disorder involving multiregional neural network connectivity alteration reflecting this. Neuromodulation targeting the central nervous system could therefore be considered and explored as a new potential therapeutic option for LD in the future, and should assist in elucidating the underlying central mechanisms responsible for causing the condition.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977126","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":"Exploring the Impact of Amyotrophic Lateral Sclerosis on Otolaryngological Functions.","authors":"Estephania Candelo, Srivatsa Surya Vasudevan, Daniela Orellana, Abigail M Williams, Amy L Rutt","doi":"10.1016/j.jvoice.2024.07.025","DOIUrl":"https://doi.org/10.1016/j.jvoice.2024.07.025","url":null,"abstract":"<p><strong>Importance: </strong>Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by progressive degeneration of upper and lower motor neurons at the spinal or bulbar level.</p><p><strong>Objective: </strong>We aim to describe the most frequent otolaryngology (ORL) complaints and voice disturbances in patients with bulbar onset ALS.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single-center study with combined ORL and ALS clinic evaluation.</p><p><strong>Participants: </strong>Patients with a confirmed diagnosis of ALS following an ORL visit and who underwent comprehensive voice assessments between January 2021 and January 2023.</p><p><strong>Exposure: </strong>Objective voice assessments.</p><p><strong>Main outcomes and measures: </strong>Glottal functional index (GFI), voice handicap index (VHI), reflux system index (RSI), and voice quality characteristics such as shimmer, jitter, maximum phonation time (MPT), and other essential parameters were assessed.</p><p><strong>Results: </strong>One hundred and thirty-three patients (age 62.17 ± 10.79, 54.48% female) were included. Three patients were referred from the ORL department to the ALS clinic. The most frequent symptoms were; dysphagia, dysarthria, facial weakness, pseudobulbar affect, and sialorrhea. The mean of forced vital capacity was 59.85%, EAT-10 15.91 ± 11.66, RSI 25.84 ± 9.03, GFI 14.12 ± 5.58, VHI-10 42.81 ± 34.94, MPT 15.22 s ± 8.06. Many patients reported voice impairments mainly related to spastic dysarthria and the combination of lower and upper motor neuron dysarthria, hypernasality, reduced verbal expression, and articulatory accuracy. Shimmer was increased to 8.46% ± 7.20, and jitter to 2.26% ± 1.39.</p><p><strong>Conclusions and relevance: </strong>Based on our cohort, this population with bulbar onset ALS has a higher frequency of voice disturbance characterized by hypernasality, spastic dysarthria, and reduced verbal expression.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977127","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}