Journal of Voice最新文献

{"title":"Superior Laryngeal Nerve Block in Transcutaneous Vocal Fold Injection: A Pilot Study","authors":"Do Won Kim ,&nbsp;Hanju Lee ,&nbsp;Jeong-Yeon Ji ,&nbsp;Ramla Talib Mohammad ,&nbsp;Gene Huh ,&nbsp;Woo-Jin Jeong ,&nbsp;Wonjae Cha","doi":"10.1016/j.jvoice.2023.03.015","DOIUrl":"10.1016/j.jvoice.2023.03.015","url":null,"abstract":"<div><h3>Objectives</h3><div><span>Topical lidocaine remains the mainstay for anesthesia in transcutaneous vocal fold<span> injection (VFI). While using topical lidocaine, laryngologists sometimes encounter uncontrolled reflexes or poor compliance. Superior laryngeal nerve block (SLNB) provides deep and rapid anesthesia on the </span></span>larynx above the vocal folds and abolishes the glottic closure reflex. Herein, we present a pilot study to evaluate the feasibility and safety of SLNB for transcutaneous VFI and explored its usefulness.</div></div><div><h3>Methods</h3><div><span>Fifty-nine patients were prospectively anesthetized with SLNB during transcutaneous VFI for unilateral vocal fold paralysis. In the SLNB group, 0.5 to 1 mL of 2% lidocaine was infiltrated on bilateral SLNs through the thyrohyoid membrane. As the control group, we included previous 47 patients who underwent VFI with topical lidocaine. In the control group, 10% lidocaine spray was applied to the laryngopharyngeal </span>mucosa. Demographic data, laryngeal exposure, patient compliance, procedural interruption, and complications were investigated. Patient compliance was evaluated based on the frequency of cough and swallowing during VFI procedures.</div></div><div><h3>Results</h3><div><span>SLNB enabled endoscopic contact on the epiglottis and pharyngeal wall without gag reflex and provided good exposure of the procedure field on the vocal folds. In the SLNB group, the laryngeal exposure is significantly better than in the control (</span><em>P</em> = 0.005). The frequency of cough and swallowing was significantly lower in the SLNB group than in the control (<em>P</em> &lt; 0.001). The number of procedural interruptions was lower in the SLNB group than in the control (<em>P</em> &lt; 0.001). There was no acute or delayed complication related to SLNB such as bleeding, hematoma, delayed sensory/swallowing problems, or unscheduled hospital visits.</div></div><div><h3>Conclusions</h3><div>SLNB might be safe and effective for anesthesia in transcutaneous VFI. SLNB could be a good anesthetic option for patients with poor compliance despite the sufficient application of topical lidocaine.</div></div><div><h3>Level of Evidence</h3><div>4</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1417.e11-1417.e16"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9813795","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":"Novel Respiratory Therapy for the Improvement of Post COVID Condition Symptoms: A Case Series","authors":"Hadas Golan ,&nbsp;Rosalba Courtney ,&nbsp;Jeremy Wolfberg","doi":"10.1016/j.jvoice.2023.04.024","DOIUrl":"10.1016/j.jvoice.2023.04.024","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Speech-language pathologists are seeing a growing number of patients whose voice and upper airway symptoms are complicated by dyspnea, cognitive difficulties, anxiety, extreme fatigue, and other debilitating post COVID symptoms. These patients are often less responsive to traditional speech-language pathology treatments and there is emerging literature that suggests dysfunctional breathing (DB) might contribute to dyspnea and other symptoms in this patient population. Treatment of DB through breathing retraining has been shown to improve breathing and successfully reduce symptoms similar to those seen in patients with </span>long COVID. There is some preliminary evidence that breathing retraining is helpful for patients with post COVID condition symptoms. However, breathing retraining protocols tend to be heterogeneous and are often not systematic or well described.</div></div><div><h3>Methods</h3><div><span>This case series reports on an Integrative Breathing Therapy<span><span> (IBT) protocol used in patients diagnosed with post COVID condition symptoms attending an otolaryngology clinic who presented with </span>signs and symptoms of DB. A systematic evaluation of the biomechanical, biochemical, and psychophysiological dimensions of DB based on principles of IBT was performed on each patient to enable targeted patient-centered care. Patients were then provided with intensive breathing retraining that aimed to comprehensively improve breathing functionality in all these three dimensions of breathing. Treatment involved 6–12 sessions of weekly 1-hour group </span></span>telehealth sessions combined with 2–4 individual sessions.</div></div><div><h3>Results</h3><div>All participants showed improvements in the parameters of DB measured and also reported a reduction in symptoms and improved daily function.</div></div><div><h3>Conclusions</h3><div>These findings suggest that patients with long COVID who present with signs and symptoms of DB might respond positively to comprehensive and intensive breathing retraining that addresses biochemical, biomechanical, and psychophysiological dimensions of breathing. More research is required to further refine this protocol and confirm its effectiveness through a controlled trial.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1411.e1-1411.e9"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10005390","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":"Augmentation-lateralization for Unilateral Vocal Fold Palsy With Airway Obstruction: A New Concept in Laryngology","authors":"Noémie Dutrieux ,&nbsp;Christol Fabre ,&nbsp;Meghana Chanamolu ,&nbsp;Paul Francis Castellanos ,&nbsp;Ihab Atallah","doi":"10.1016/j.jvoice.2023.02.032","DOIUrl":"10.1016/j.jvoice.2023.02.032","url":null,"abstract":"<div><h3>Objectives</h3><div><span>This study presents an efficient, safe, effective, and novel technique of reconstructive transoral laser microsurgery (R-TLM) for the treatment of unilateral </span>vocal fold<span> paralysis (UVFP) with airway obstruction. It is based on the augmentation of the immobile and potentially flaccid and atrophic side while lateralizing the arytenoid and posterior part of the vocal fold, thus improving breathing without sacrificing phonation and commonly improving it.</span></div></div><div><h3>Study Design</h3><div>Retrospective cohort study<span> through data from medical records and operative notes.</span></div></div><div><h3>Methods</h3><div>Patients with UVFP with exertional dyspnea with or without dysphonia<span> were included in this report. The vocal fold is augmented by harvesting the aryepiglottic fold soft tissues and the upper part of the arytenoid and placing them into the paraglottic space as a pedicled microflap, thus augmenting the anterior two thirds of the vocal fold while lateralizing the remaining arytenoid and posterior third of the vocal fold by an internal traction suture to improve airway. Postoperative breathing, phonation and swallowing were assessed.</span></div></div><div><h3>Results</h3><div><span>Twenty two cases are reported in the study. Follow-up evaluations ranged from 6 to 12 months. All cases showed successful and durable improvement of breathing and phonation. None required tracheostomy or </span>gastrostomy pre- or postoperatively.</div></div><div><h3>Conclusions</h3><div>Augmentation-lateralization is a novel, safe, and effective minimally invasive technique that allows airway improvement with good results on phonation in patients with challenging UVFP with airway obstruction.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1390-1397"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192642","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":"Methods of Measuring Laryngeal Muscle Tension in Patients with Muscle Tension Dysphonia: A Scoping Review","authors":"Claire M. Thomas,&nbsp;David Rhodes,&nbsp;Melanie Mehta,&nbsp;Jill Alexander","doi":"10.1016/j.jvoice.2023.03.013","DOIUrl":"10.1016/j.jvoice.2023.03.013","url":null,"abstract":"<div><h3>Background</h3><div>In clinical practice and research relating to Muscle Tension Dysphonia (MTD), several laryngeal muscle tension measurement methods are used to diagnose, to identify specific muscle strengths and deficits, and to measure therapeutic outcomes. The variety and reliability of available measurement methods presents challenges within diagnosis and treatment. The lack of methodical standardization presents a barrier to homogeneous practice in this area. There is a need for a comprehensive scoping review of laryngeal muscle tension measurement methods.</div></div><div><h3>Study Design</h3><div>Scoping review.</div></div><div><h3>Objectives</h3><div>(1) To identify current methods of laryngeal muscle measurement which have been developed or tested with people with MTD; and (2) To identify the construct/s measured, reliability, validity, ability to detect change, efficiency and accessibility of identified methods.</div></div><div><h3>Method</h3><div>This scoping review was conducted using the Arksey and O'Malley framework. Studies were identified through searches of 4 major databases. The reviewer independently assessed titles, abstracts, and full-text articles.</div></div><div><h3>Results</h3><div>Twenty seven papers published from 2000 to 2022 that satisfied the inclusion criteria were selected from 194 studies. The papers showed a variety of approaches with regards to the measurement of laryngeal activity and tension in subjects with MTD. Just over a quarter (25.9%) were reviews of the validity of assessment methods of MTD, including surface electromyography (sEMG), while 22.2% discussed surface electromyography as a measurement of muscle activity in subjects with MTD. 96.3% used a published methodological framework.</div></div><div><h3>Conclusions</h3><div>Assessment methods for Primary MTD are multifaceted, including patient history, laryngoscopic examination, and voice-related musculoskeletal features. Potential use of objective measurement methods, including sEMG, Real Time Elastosonography, Magnetic Resonance Imaging was noted. Due to variability in assessment methods and results, there is a need for greater objective practical methodological standardization to ensure accurate diagnosis, appropriate care, and chart patient progress.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1409.e15-1409.e41"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315272","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":"Evaluation of Safety After Intracordal Basic Fibroblast Growth Factor Injection","authors":"Tomohiro Hasegawa ,&nbsp;Retsu Fujita ,&nbsp;Daigo Komazawa ,&nbsp;Ujimoto Konomi ,&nbsp;Mayu Hirosaki ,&nbsp;Yusuke Watanabe","doi":"10.1016/j.jvoice.2023.03.007","DOIUrl":"10.1016/j.jvoice.2023.03.007","url":null,"abstract":"<div><h3>Objectives</h3><div>Although there are many reports of voice improvement with intracordal trafermin (a basic fibroblast growth factor) injections under local anesthesia, few papers have documented the safety of trafermin. Therefore, we aimed to investigate whether trafermin is safer than control drugs (triamcinolone acetonide) early after intracordal injection under local anesthesia.</div></div><div><h3>Methods</h3><div><span>We conducted a retrospective review from the medical records of patients who underwent intracordal injection with trafermin and </span>triamcinolone acetonide under local anesthesia at our institution. Early postinjective complications were defined as changes in vital signs and chief complaints early after intracordal injection.</div></div><div><h3>Results</h3><div><span>A total of 699 and 297 patients underwent intracordal injection under local anesthesia with trafermin and triamcinolone acetonide, respectively. Of these, 227 and 130 patients had early postinjective complications with trafermin and triamcinolone acetonide, retrospectively. The most common complications occurring with trafermin was increased blood pressure in 39 cases (5.58%): 17 cases (2.43%) of blood pressure increase of ≥20 mm Hg. Other complications included pharyngeal discomfort in 37 (5.29%), </span>lightheadedness<span> in 33 (4.72%), and phlegm discharge in 29 (4.15%). Triamcinolone acetonide caused pharyngeal discomfort in 28 patients (9.43%), phlegm discharge in 17 patients (5.72%), lightheadedness<span> in 12 patients (4.04%), sore throat in 11 patients (3.70%), increased blood pressure in 10 patients (3.37%): 7 cases (2.36%) of blood pressure increase of ≥20 mm Hg, and dizziness in seven patients (2.36%). Statistical analysis of the complications between trafermin and triamcinolone acetonide showed no significant differences.</span></span></div></div><div><h3>Conclusions</h3><div>The proportion of early postinjective complications from intracordal injection of trafermin is no significant difference in that of triamcinolone acetonide. The results suggest that the early postinjective complications are not due to the drug action of trafermin, but rather to complications from the intracordal injection procedures. Intracordal trafermin injection may be safe in the short term.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1419.e29-1419.e37"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9313956","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":"Pediatric Dysphonia and the Access to Voice Therapy: A Study in Speech-Language Patology Services Available in a Capital City in the Northeast of Brazil","authors":"Neuza J. Sales ,&nbsp;Anne T.S. Sampaio ,&nbsp;D..borah Pimentel ,&nbsp;Eleonora Ramos de Oliveira ,&nbsp;Valeria M. Prado-Barreto ,&nbsp;Jeferson S. d...Avila ,&nbsp;Daniel F.N. Castaneda ,&nbsp;Ikaro Daniel de Carvalho Barreto ,&nbsp;Ricardo Q. Gurgel","doi":"10.1016/j.jvoice.2023.05.001","DOIUrl":"10.1016/j.jvoice.2023.05.001","url":null,"abstract":"<div><h3>Objectives</h3><div><span>Describe the vocal fold alteration and </span>dysphonia<span> in the pediatric group studied in private speech-language pathology facilities, and estimating the time period between the problem being identified by the parents and the access to the proper provided services.</span></div></div><div><h3>Method</h3><div>Analytical cross-sectional survey study with data collected from medical records by the speech-language pathology of each private facility. A written form was prepared and sent to the speech-language pathology of the 40 existing facilities. We received 124 of them from the pediatric group being assisted in 15 of the facilities. The form included questions about sex, age, vocal complaints; general severity of dysphonia; otorhinolaryngological diagnosis of vocal fold alteration the age that the problem was identified by the parents, and the beginning of voice therapy. All of them were examined by GRBAS, 37 boys and 30 girls by videonasopharyngolaryngoscopy.</div></div><div><h3>Results</h3><div>The time period between the identification of the participant's dysphonia by the parents and the start of voice therapy was considered long (3.5 years). The group showed variance in the proportion of nodules and cyst between sexs. The highest prevalence of nodules occurred in boys; and the cyst in girls. General moderate of dysphonia occurred between 4 and 17 years old, average age of 7 years and 7 months, with greater distribution between 5 and 10 years of age.</div></div><div><h3>Conclusion</h3><div>The average time delay until the start of voice therapy was 3.5 years, more frequently in the 5...10 years group and due to nodules in boys and cysts in girls.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1412.e15-1412.e21"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776217","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 Relationship Between the Stomatognathic System and Voice in Classical Singers","authors":"Rafaela Lombas de Resende,&nbsp;Maria Fernanda Bagarollo,&nbsp;Ana Carolina Constantini","doi":"10.1016/j.jvoice.2023.04.018","DOIUrl":"10.1016/j.jvoice.2023.04.018","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate stomatognathic system...s structures and functions in classical singers, relating them to the auditory-perceptual judgment of voice quality and voice self-perception.</div></div><div><h3>Methods</h3><div>A.ßcross-sectional pilot study was conducted to evaluate the Stomatognathic System (SS) using orofacial myofunctional evaluation (MBGR Protocol). Voice handicap self-perception was assessed by the Classical Singing Handicap Index (CSHI) and the Voice Handicap Index (VHI-10). Voice samples, recorded according to the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol, underwent auditory-perceptual judgment by two voice experts. All statistical analyses adopted a 5% significance level.</div></div><div><h3>Results</h3><div><span>The study included 15 classical singers (nine women and six men). Adequate assessments of lip and tongue functionality and mobility, upper and lower lip, mentum, and tongue tone were higher compared with altered assessments (</span><em>P</em>.ß&lt;.ß0.001). Nasal and oronasal breathing showed similar proportions among singers (<em>P</em><span>.ß=.ß0.273). Participants reported greater pain in the masseter muscle (</span><em>P</em><span>.ß..±.ß0.001), temporomandibular joint (TMJ) (</span><em>P</em><span>.ß..±.ß0.001), and sternocleidomastoid muscle (SCM), especially on the left side (</span><em>P</em>.ß..±.ß0.001). MBGR score showed no association with singers... voice handicap and voice quality self-perception.</div></div><div><h3>Conclusion</h3><div>MBGR-evaluated SS items were not related to auditory-perceptual judgment of voice quality.ßand voice self-perception. Singers reported more pain with palpation in the SCM, masseter muscle, and TMJ. Preference for a chewing side was higher than bilateral chewing. Assessing SS is paramount for the multidimensional evaluation of classical singers... voice.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1412.e9-1412.e14"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000690","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":"Efficacy of the Grit Scale Score in Predicting Voice Therapy Adherence and Outcomes","authors":"Chetna Chopra ,&nbsp;Edward Gracely ,&nbsp;Ghiath Alnouri ,&nbsp;Bridget Rose ,&nbsp;Robert T. Sataloff","doi":"10.1016/j.jvoice.2023.04.016","DOIUrl":"10.1016/j.jvoice.2023.04.016","url":null,"abstract":"<div><h3>Background</h3><div><span>Voice therapy generally is considered first-line treatment for dysphonia<span> and vocal fold </span></span>paresis. It requires a commitment of time, effort and resources; currently, there is no good indicator to identify which patients are good candidates for voice therapy. The Grit scale, developed by psychologist Angela Duckworth, provides a method to quantify perseverance and commitment to long-term goals.</div></div><div><h3>Objective</h3><div>We hypothesized that the Grit scale score could correlate with patient adherence to voice therapy and outcomes, by which subjects with higher Grit scale scores demonstrate greater adherence and better outcomes.</div></div><div><h3>Methods</h3><div>Subjects were categorized into five groups, subjects who (1) were discharged from therapy after successful completion, (2) improved to normal, near-normal, or a level of voice function with which the patients were satisfied, and then stopped attending therapy (3) attended as at least the recommended number of sessions or greater than 8 sessions with some voice improvement (4) failed to improve to a voice function level satisfactory to the patient despite attending voice therapy, (5) failed to attend voice therapy as recommended. Subjects in groups 1–4 were considered adherent to voice therapy, whereas group 5 was considered not adherent. Category 1 was considered the most favorable outcome, whereas Category 5 was considered the least favorable outcome (1 &gt; 2 &gt; 3 &gt; 4 &gt; 5).</div></div><div><h3>Results</h3><div>Eighty-nine subjects are included in the study. The average age of subjects was 44.9 years old, and there was a nearly equal split between male and female subjects. The mean Grit score (48) of the adherent group (categories 1–4) was not significantly different from that of the non-adherent group (47, <em>P</em> = 0.190). Spearman's rho between Grit scale score and the categories (1 &gt; 2 &gt; 3 &gt; 4 &gt; 5) was 0.0674, <em>P</em> = 0.530.</div></div><div><h3>Conclusion</h3><div>Neither the analysis by groups nor the Spearman correlation across all categories supported our hypothesis that higher Grit scale scores would be associated with better adherence and outcomes. The failure of the Grit scale score to predict adherence to voice therapy and outcomes emphasizes the need for further research to find a metric that will help predict and improve patient adherence with voice therapy and voice outcomes. Further research is needed to determine why it was unable to be predictive and to confirm or refute our findings.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1414.e17-1414.e21"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10181870","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":"Acoustic-Aerodynamic Voice Outcome Ratios Identify Changes in Vocal Function Following Vocal Fold Medialization for Unilateral Vocal Fold Paralysis","authors":"Latané Bullock ,&nbsp;Laura E. Toles ,&nbsp;Robert E. Hillman ,&nbsp;Daryush D. Mehta","doi":"10.1016/j.jvoice.2023.03.011","DOIUrl":"10.1016/j.jvoice.2023.03.011","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to determine whether ratio-based measures that combine acoustic (output) and aerodynamic (input) parameters detect postoperative change in vocal function following vocal fold medialization for unilateral vocal fold paralysis.</div></div><div><h3>Method</h3><div>Pre- and postoperative acoustic and aerodynamic measures were analyzed retrospectively from 149 patients who underwent vocal fold medialization for unilateral vocal fold paralysis. A 2 × 2 repeated-measures analysis of variance was conducted for each of four acoustic-aerodynamic ratios—traditional vocal efficiency (VE), sound pressure level to aerodynamic power (SPL/AP), SPL to average airflow (SPL/AFLOW), and SPL to subglottal pressure (SPL/Ps)—to investigate the main effects and interaction of treatment stage and loudness level (comfortable and loud).</div></div><div><h3>Results</h3><div>The patient group showed significant postoperative improvements in self reports of vocal function (voice-related quality of life) and clinical auditory-perceptual judgments of dysphonia (consensus auditory-perceptual evaluation of voice). Main effects for both treatment stage and loudness level were statistically significant for all measures except SPL/Ps. There were interaction effects for VE and SPL/AP, suggesting that magnitude of the treatment effect differs based on loudness. SPL/AFLOW had medium-to-large effect sizes in both loudness conditions. There were postoperative changes in SPL/Ps that were dependent on the magnitude of the reduction in AFLOW; as expected, SPL/Ps increased postoperatively in a subgroup that had large postoperative reductions in AFLOW at the comfortable loudness level.</div></div><div><h3>Conclusions</h3><div>Acoustic-aerodynamic ratios can aid in tracking changes in vocal function following vocal fold medialization. SPL/AFLOW exhibited the largest effect size, which is expected since a reduction in abnormally high AFLOW typically accompanies the increased modulation of glottal air flow associated with successful vocal fold medialization. Future study is needed to model physiological changes in acoustic-aerodynamic voice outcome ratios across different types of voice disorders.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1419.e13-1419.e27"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9710634","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":"Dysphonia and Throat Clearing in Singers During the COVID-19 Pandemic in Brazil","authors":"Sabryna Farneze Nunes Sant'anna,&nbsp;André de Campos Duprat,&nbsp;Marta Assumpção de Andrada e Silva,&nbsp;Maria Fernanda de Queiroz Prado Bittencourt","doi":"10.1016/j.jvoice.2023.05.008","DOIUrl":"10.1016/j.jvoice.2023.05.008","url":null,"abstract":"<div><h3>Objective</h3><div>The COVID-19 pandemic in Brazil affected the lives of singers, with negative impacts of the disease on the voice, such as dysphonia and throat clearing. This study aims to evaluate the presence of dysphonia and throat clearing in singers during the COVID-19 pandemic in Brazil.</div></div><div><h3>Material and Methods</h3><div>This is a cross-sectional analytical study with a sample of 154 singers from all over Brazil. Data collection was carried out online, by completing the questionnaire created by the researcher using Google Forms<em>.</em> The following were considered the outcome variables: voice impairment and throat clearing. The bivariate analysis was performed to test the relationship between COVID-19 infection and voice impairment, COVID-19 infection and throat clearing, COVID-19 infection and laryngeal complaints (voice impairment and throat clearing).</div></div><div><h3>Results</h3><div>In this study, the mean age of the singers was 35.8 (Standard deviation = ±10.2 years) and 59.2% were female. Most of them worked as professional singers (81.1%) and had more than 10 years of professional experience (57.4%), mainly singing pop music (85.4%). A total of 62% reported vocal alterations during the COVID-19 infection and 53% had vocal alterations after the infection, with 44.0% reporting the onset of throat clearing after the infection. There was a significant association between COVID-19 infection and having voice impairment (<em>P</em> = 0.03; prevalence ratio – PR: 2.33; CI: 1.04–5.46). An association was observed between the onset of throat clearing and the occurrence of COVID-19 infection (<em>P</em> = 0.001; PR: 9.13; CI: 2.47–64.42).</div></div><div><h3>Conclusions</h3><div>The results indicated that there is an association between COVID-19 infection and complaints of dysphonia and throat clearing in Brazilian singers. This study demonstrates the importance of guidance to singers infected with COVID-19 by health voice processionals.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 5","pages":"Pages 1414.e1-1414.e7"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10362075","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}