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Objective: Numerous methods and materials are available for vertical partial laryngectomy. In this study, the reparative effects of the platysma myocutaneous flap (PMF) and ribbon myocutaneous flap (RMF) on the postoperative voice quality of patients were compared to provide a reference for selecting a method conducive to improving postoperative voice quality. Methods: A retrospective analysis was performed on patients with unilateral T2‐3 glottic carcinoma. Following vertical partial laryngectomy, the defect was repaired with a PMF or simple RMF. Twelve months after surgery, voice quality was assessed according to voice acoustics, aerodynamics, and subjective perceptual evaluation, and glottic morphology was recorded using a laryngeal stroboscopy. Results: A total of 70 patients were identified, including 54 in the PMF group and 16 in the RMF group. The PMF group was superior to the RMF group in terms of voice quality assessed by voice acoustics, aerodynamics, and subjective perceptual evaluation. In the PMF group, 72.2% of patients performed phonation with their vocal cords, and approximately 27.8% of patients were affected by supraglottic compression. In the RMF group, 81.3% of patients were affected by supraglottic compression. No significant difference was found in the 5‐year survival rate between the two groups. Conclusion: For defect repair following vertical partial laryngectomy, a PMF can allow better postoperative voice quality to be achieved than an RMF because a PMF can provide more tissue (including strap muscle under the flap) for padding, which enables the glottic portion corresponding to the vocal cord to close well. Level of Evidence: 3 Laryngoscope, 134:3181–3186, 2024 [ABSTRACT FROM AUTHOR]

There is a lack of effective treatment for idiopathic unilateral vocal fold paralysis (IUVFP). A better phonation was reported by patients after laryngeal nerve stimulation during our clinical examination. This study aims to investigate immediate effect of recurrent laryngeal nerve (RLN) stimulation on phonation in patients with IUVFP. Sixty-two patients with clinically identified IUVFP underwent RLN stimulation with needle electrodes. Laryngoscopy, acoustic analysis, and voice perception assessment were performed for quantitative comparison of vocal function and voice quality before and after the intervention. Laryngoscopic images showed a larger motion range of the paralyzed vocal fold (p <.01) and better glottal closure (p <.01) after RLN stimulation. Acoustic analysis revealed that the dysphonia severity index increased significantly (p <.01) while the jitter and shimmer decreased after the intervention (p <.05). According to perceptual evaluation, RLN stimulation significantly increased RBH grades in patients with IUVFP (p <.01). Furthermore, the improvement in voice perception had a moderate positive correlation with the decrease in the glottal closure. This study shows a short-term improvement of phonation in IUVFP patients after RLN stimulation, which provides proof-of-concept for trialing a controlled delivery of RLN stimulation and assessing durability of any observed responses. [ABSTRACT FROM AUTHOR]

Society has become increasingly dependent on telecommunication, which has been shown to negatively impact vocal function. This study explores the use of sidetone regulation during audio-visual communication as one potential technique to alleviate the effects of telecommunication on the voice. The speech acoustics of 18 participants with typical voices were measured during conversational tasks during three conditions of sidetone amplification: baseline (no sidetone amplification), low sidetone amplification, and high sidetone amplification. Vocal intensity, vocal quality (estimated using acoustic measures of the low-high ratio and the smoothed cepstral peak prominence), and self-perceived vocal effort were used to measure the impacts of sidetone amplification on vocal function. Compared to baseline, there were statistically significant decreases in vocal intensity and increases in low-high ratio in the high level of sidetone amplification condition. Changes in these measures were not significantly correlated. When asked to rank conditions based on their perceived vocal effort, participants most often ranked the high level of sidetone amplification as least effortful; however, the visual-analog ratings of vocal effort were not significantly different between conditions. The smoothed cepstral peak prominence did not change with varying levels of sidetone amplification. Vocal intensity decreased with high levels of sidetone amplification. High levels of sidetone amplification also resulted in increases in the low-high ratio, which were shown to be more than just a byproduct of decreased vocal intensity. The impact of sidetone amplification on vocal effort was less clear, but results suggested that participants generally decreased their vocal effort with increased levels of sidetone amplification. This was a preliminary study and future work is warranted in a population of participants with voice complaints and in a more noisy, realistic environments. [ABSTRACT FROM AUTHOR]

Introduction: Correct breathing is a fundamental condition for adequate vocal production. Respiratory dynamics are able to modify the growth of facial mass and lingual posture, i.e., of the skull, the mandibular one. For this reason, infant mouth breathing can cause hoarseness. Materials and methods: We evaluated the actual changes in the characteristics of the voice and articulation of language in a group of subjects affected by adenotonsillar hypertrophy (grade 3–4), with frequent episodes of pharyngo-tonsillitis who underwent adenotonsillectomy. Our study included 20 children—10 boys and 10 girls—aged 4 to 11 years who had adenotonsillar hypertrophy and pharyngotonsillitis episodes exceeding 5–6 per year in the previous 2 years. The control group (Group B) included 20 children—10 boys and 10 girls—aged 4 to 11 years (average age of 6.4 years) who had not undergone surgery and shared the same degree of adenotonsillar hypertrophy as those in Group A but who did not experience recurrent pharyngotonsillitis episodes. Discussion: The hypertrophy of adenoids and tonsils significantly impacted breathing, vocal function, and speech articulation. All this is responsible for a state of tension in the neck muscles, which at the level of the vocal tract causes hoarseness. The changes objectively observed in our study in the pre- and post-operative phase demonstrate how adenotonsillar hypertrophy is responsible for an increase in resistance to the passage of air at the glottic level. Conclusions: For this reason, adenotonsillectomy has an impact on recurrent infections and can also lead to an improvement in speech, breathing, and posture. [ABSTRACT FROM AUTHOR]

Background: The involvement of the larynx in many situations can have a substantial impact on a person's voice, breathing, and general health. Individuals with autoimmune thyroid disorders can experience a variety of conditions affecting the larynx. Autoimmune thyroid disorders, such as Hashimoto's thyroiditis [HT] and Graves' disease [GD], are prevalent conditions affecting the thyroid gland. Beyond their established impact on thyroid function, these disorders have been associated with laryngeal involvement. The current study aims to explore the likelihood of laryngeal involvement in patients with Autoimmune Thyroid Disorders [AITD]., Method: This study involved a retrospective analysis of medical records from patients diagnosed with autoimmune thyroid disorders. Inclusion criteria were a confirmed diagnosis through laboratory investigations and clinical assessment. Patients with pre-existing laryngeal pathologies or other conditions affecting the larynx were not considered. We collected data from 4 research articles and 3 clinical trials from Embase, PubMed, and NCBI-Trials portals, focusing on reported laryngeal symptoms. The severity of laryngeal involvement was assessed and categorized based on its extent and impact on vocal function., Results: Preliminary analysis of the collected data indicated a significant proportion of patients with autoimmune thyroid disorders reporting laryngeal symptoms. Among these patients, various manifestations of laryngeal involvement were observed, including vocal changes, hoarseness, and throat discomfort., Conclusion: The findings show that laryngeal symptoms may be an underappreciated feature of these diseases, potentially impacting vocal function and quality of life in affected people. Further research is also needed for more precise projections in this direction., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Participation in sorority recruitment often results in acute vocal impairment. The purpose of this investigation was to characterize the extent to which voice function and laryngeal appearance may be altered by participation in this social phenomenon. Using a within-participant repeated measures design, nine women participating as sorority recruiters completed the study protocol. The following data were collected at two time points, immediately before and after the completion of two weeks of sorority recruitment: stroboscopic laryngeal imaging, vocal acoustic measures, and perceptual measures of vocal effort and voice quality. Perceived phonatory effort and overall severity of voice quality were significantly impaired following sorority recruitment. All participants had evidence of mucosal changes in the form of one or more the following: observed edema, erythema, increased vascularity, glottic margin changes. No significant differences in acoustic measures were identified. Increased perceived vocal effort, increased overall severity ratings of voice quality, and deleterious vocal fold tissue changes observed support the hypothesis that the acute vocal loading that is characteristic of the sorority recruitment process contributes to a decline in voice function in the short term. Acoustic measures taken either lacked the sensitivity for the perceived decline in voice function or the participants, who were otherwise healthy, managed to adapt the acoustic signal to the tissue changes observed. The extent to which these acute changes may be mitigated with vocal hygiene and voice training is an area for future study. [ABSTRACT FROM AUTHOR]

Objective: To compare vocal function between females with benign vocal fold lesions, and females with normal voices by use of electroglottograph (EGG), also in addition to determining which EGG parameters were significantly correlated with the perceptual degree of dysphonia. Material and Methods: EGG data were obtained from 32 females with benign vocal fold lesions and 32 females with normal voices. The EGG parameter values were analyzed from their productions of four sustained vowels (/a:/, /u:/, /i:/, and /æ:/). Results: The two perturbation measures of EGG signals, EGG-jitter and EGG-shimmer of females with benign vocal fold lesions were significantly higher than those of normal females at a p-value

Purpose: The primary goal of this investigation was to characterize the effect of the first-generation, over-the-counter antihistamine Chlor-Trimeton on laryngeal structure and function in a previously unstudied population - individuals diagnosed with allergic rhinitis who routinely take over-the-counter antihistamines and deny the experience or diagnosis of voice disorder., Study Design: Prospective within-participant multimodality repeated measures design., Methods: Eight consented participants (seven females, one male) previously diagnosed with allergic rhinitis and without history of voice disorder who routinely took over-the-counter antihistamines completed the study. Volunteers completed the following measures before and 2hours after antihistamine administration: perceptual vocal function measures, phonation threshold pressure (PTP), acoustic measures, and laryngeal imaging. All pre- and post-administration data were descriptively analyzed for clinically significant change., Results: No clinically significant differences were identified for any acoustic or aerodynamic measures taken. Analyses of laryngeal imaging data indicated that all participants had evidence of mucosal changes in one or more of the following parameters: increased vascularity, mucus in the anterior commissure, and vocal fold color changes, all of which are consistent with prior descriptions of allergy larynx., Conclusions: Empirical study of laryngeal appearance in individuals diagnosed with allergic rhinitis, affirmed clinical observations of laryngeal tissue changes consistent with allergy larynx. Stable PTP suggests potential vocal fold cover adaptations from routine use of over-the-counter antihistamines that may buffer the typical desiccating effect on voice function observed in prior studies of healthy individuals., Competing Interests: Declaration of Competing Interest The authors have no personal or financial disclosures to report. This investigation represents novel work that has not been presented or published elsewhere., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate voice quality evolution after a transoral laser cordectomy (TLC) for precancerous lesions and early glottic cancer. Methods: This prospective study enrolled 18 patients scheduled for TLC for high-grade dysplasia, Tis, T1, and T2 glottic squamous cell cancers, from May 2017 to March 2020. Patients were grouped according to the extent of TLC: Group I (n = 11, 61.1%): unilateral subepithelial or subligamental cordectomy; Group II (n = 7, 38.9%): unilateral transmuscular, total, or extended cordectomy. Voice quality parameters, including dysphonia grade (G), roughness (R), breathiness (B), maximal phonation time (MPT), jitter, and shimmer, were evaluated before, and at 6 weeks and 6 months after the TLC. Results: In Group I, the degree of G and R items remained without substantial improvement 6 weeks after surgery; however, improved above the pre-surgery level up to 6 months after surgery. The MPT, jitter, and shimmer did not change significantly at 6 weeks or 6 months post-TLC. In Group II, G, R, and B remained significantly impaired even 6 months post-surgery. Jitter, and shimmer worsened at 6 weeks, but reached preoperative levels at 6 months post-surgery. MPT was significantly worse at 6 weeks and remained deteriorated at 6 months post-surgery. All measured parameters were significantly worse in Group II than in Group I at 6 weeks and 6 months post-surgery. No patient required a phonosurgical procedure. Conclusion: After a TLC, voice quality evolution depended on the extent of surgery. It did not improve at 6 weeks post-surgery. Improvements in less extent cordectomies occurred between 6 weeks and 6 months post-surgery. Understanding voice development over time is important for counseling patients when considering phonosurgical procedures. [ABSTRACT FROM AUTHOR]

The platysma skin flap was used for laryngeal reconstruction after vertical partial laryngectomy to improve the postoperative voice quality of patients with T2 and T3 glottic laryngeal carcinoma. Sixty‐nine patients with unilateral T2 and T3 glottic laryngeal carcinoma were included. Forty‐six patients received vertical partial laryngectomy, and a platysma skin flap was used for laryngeal reconstruction. The other 23 patients underwent transoral laser microsurgery. Subjective and objective examinations were performed to evaluate laryngeal morphology after the surgery. Acceptable voice quality was achieved for 46 patients who underwent vertical partial laryngectomy. Flap vibrational waves occurred in 19 cases (41.3%). The platysma skin flap is an ideal tissue for the reconstruction of articulation structure in open surgery of T2 and T3 unilateral glottic laryngeal carcinoma. [ABSTRACT FROM AUTHOR]

In Hamilton: An American Musical, four actors play the following dual roles: Peggy Schuyler/Maria Reynolds, Marquis de Lafayette/Thomas Jefferson, Hercules Mulligan/James Madison, and John Laurens/Philip Hamilton. In addition to changes in costumes, hair, and physicality, the actor produces a distinctive vocal sound for each character. This study explores the specific configurations of anatomical structures within the vocal tract, which contribute to the signature sounds of the dual role characters in the Original Broadway Cast recording of Hamilton. Identified through the Estill Voice Model™, the conditions of significant vocal tract structures of each character's sound are mapped and compared. Given the popularity and heavy distribution of the cast album, it may be particularly prudent for replacement actors to sound like the original Broadway cast. Rather than relying on aural mimicry, replacement-cast hopefuls may reproduce the mapped conditions of the vocal tract to approximate a signature sound. Voice teachers, vocal coaches, music directors, and vocal directors can use specific elements of vocal function to guide an actor toward the desired sound, while preserving the actor's own indigenous sound. [ABSTRACT FROM AUTHOR]

Objectives: To compare continuous (C‐IONM) vs intermittent intraoperative neuromonitoring (I‐IONM) in complex benign thyroid surgery, and to follow up patients with loss of signal (LOS) or unilateral vocal fold paralysis (UVFP). Design: Retrospective clinical study, prospective case series. Setting: University hospital and academic teaching hospital of Charité—University Medicine Berlin, Germany. Participants: C‐IONM‐ and I‐IONM‐assisted thyroid surgery was conducted in 357 patients diagnosed with recurrent goitre, Graves' disease, complex hyperparathyroidism, cervical preoperation (anterior access) and LOS in primary operation (2‐stage thyroidectomy). Main outcome measures: To evaluate the incidence of early postoperative and permanent UVFP, and to report the results of phonosurgical therapy in patients suffering from persisting dysphonia. Results: In 346 patients enrolled (81.8% female, 18.2% male) with 613 nerves at risk (NAR) being monitored (409 I‐IONM vs 204 C‐IONM), early postoperative UVFP was observed in 10.5% of I‐IONM vs 4.9% of C‐IONM group (P < .05), permanent paralysis in 1.5% of I‐IONM vs 1.0% of C‐IONM group (P = .619). In total, 72 patients (21%) experienced pathological events (19 LOS < 100 μV, 53 transient or permanent UVFP). Three patients with permanent UVFP and persisting dysphonia received phonosurgery with stable improvements of all acoustic‐aerodynamic parameters. Conclusion: Compared to I‐IONM, C‐IONM‐application in complex benign thyroid surgery shows a significant reduction of transient UVFP and a non‐significant trend in preventing permanent UVFP. In persistent UVFP with dysphonia, endolaryngeal phonomicrosurgery and transcervical laryngeal framework surgery are long‐term effective treatment approaches to improve vocal function. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the feasibility of the submucosal infusion combined with microflap dissection via laser CO2 as both a diagnostic and therapeutic procedure for superficial glottic lesions. To define a safe surgical procedure in terms of local control, a morphometric study of surgical margins was performed. Methods: From January 2011 to January 2016, we treated 122 patients with early glottic lesions with phonomicrosurgery. Patients with effective hydrodissection underwent a microflap and type I-II diagnostic cordectomy. In the others, a biopsy was carried out, and in the case of a malignant lesion, a type III to VI cordectomy was performed. Disease-free survival (DFS) for all the lesions was also determined according to comparative assessments of surgical margins. The Voice Handicap Index was used to evaluate functional outcomes. Results: In 27 cases (32%), hydrodissection was effective; specifically, 24 (88.8%) were premalignant lesions, and 3 (11.2%) had a carcinoma. In 56 patients (68%), hydrodissection was not adequate, and a biopsy was performed: 9 (16%) were premalignant and 47 (84%) malignant lesions. The DFS analysis suggests that margins >0.7 mm resulted in a cutoff that can guarantee a safe procedure in the case of effective hydrodissection (P < .05). Conclusion: Phonomicrosurgery may be both a diagnostic and therapeutic option with oncological efficacy for superficial glottic lesions of undetermined nature when surgical margins exceed 0.7 mm. In case of inadequate hydrodissection, the hypothesis of an infiltrative carcinoma warrants a wider cordectomy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of aging on vocal function following laryngeal reinnervation combined with arytenoid adduction (AA) in the treatment of paralytic dysphonia., Methods: Sixty-eight patients with unilateral vocal fold paralysis who underwent refined nerve-muscle pedicle flap (NMP) implantation and AA were classified into four groups according to age: under 50 years (-50), in their 50s, 60s, and 70 years and older (70+). These groups consisted of 15, 14, 22, and 17 patients, respectively. Their vocal function was followed periodically for 24 months after surgery., Results: Vocal function in all groups showed significant improvement after surgery. Significant improvements in vocal function were observed during a 24-month follow-up period: maximum phonation time in the -50 and 50 seconds groups; pitch range and voice handicap index-10 in the -50, 50s, and 60s groups; "Grade" in the -50, 50s, and 70+ groups; and "Breathiness" and voice-related quality of life in all groups. There were no significant differences in vocal function among the four groups, except for pitch range, at the 24-month postoperative assessment., Conclusions: Although the younger groups tended to exhibit better vocal function compared to the older groups 24 months postoperatively, the refined NMP+AA proved effective in the treatment of breathy dysphonia resulting from unilateral vocal fold paralysis, not only in the younger population but also in the older population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: Optimal pulmonary air support is essential pre-requisite for efficient phonation. The objective is to correlate pulmonary and vocal functions in chronic obstructive pulmonary disease (COPD) to find out whether the reduced pulmonary function per se could induce dysphonia.Methods: In this prospective case-control study, sixty subjects with stable COPD underwent evaluation of pulmonary and vocal functions. The pulmonary functions measured include {Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF)}. The vocal functions were {jitter, shimmer, noise-to-harmonic ratio, pitch perturbation quotient, amplitude perturbation quotient, maximum phonation time (MPT), sound pressure level, phonatory efficiency, resistance and power. A control group (n=35) underwent the same measurements. These functions were compared between subjects and controls. Also, correlation of the vocal and pulmonary functions was conducted.Results: Thirty five (58.3%) of COPD subjects have dysphonia. The pulmonary functions were lower in all COPD group than in the control group (P<0.001 for all parameters). Also, the FVC, FEV1, PEF and MMEF % of predicted values were significantly lower in subjects with dysphonia (n=35) than those without dysphonia (n=25) with P values 0.0018, <0.001, 0.0011 and 0.0026 respectively. In addition, the MPT in all subjects showed positive correlations to the 5 pulmonary functions (P=0.004 for FEV1/FVC ratio and P<0.001 for the rest). Also, the phonatory efficiency showed significant positive correlations with the pulmonary functions FVC, FEV1, PEF and MMEF (P=0.001, 0.001, 0.002 and 0.001 respectively). Unlike efficiency, the phonatory resistance revealed significant negative correlations with these pulmonary functions in the same order (P=0.001, 0.003, 0.002, 0.001 respectively).Conclusion: Dysphonia is a common comorbidity with COPD which attributed to multifactorial etiologies. The lower the pulmonary function in COPD patients is the more likely to have dysphonia. Decreased pulmonary function was associated with reduced MPT and phonatory efficiency but with increased phonatory resistance. The reduced pulmonary functions in COPD can be the underlying cause of the altered vocal function and dysphonia. Great part of this dysphonia is functional, and hence, can be corrected by voice therapy in compensated subjects. Further researches are needed to evaluate the efficacy of voice therapy in these patients. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To evaluate the efficacy of vocal fold (VF) augmentation with calcium hydroxylapatite (CaHA) microspheres in the surgically pretreated larynx with glottal insufficiency.Study Design: Prospective clinical pilot study.Methods: After several prior reconstructive attempts (following tumor resection, VF paralysis, in sulcus vocalis, and VF scarring), CaHA was injected under general anaesthesia using a transoral microlaryngoscopic approach in 10 patients with residual glottal insufficiency ≤1.5 mm. The postinterventional result was assessed after 1 day, and 1 and 3 months. Evaluation of augmentation comprised intraoperative video/photo documentation, pre-/postoperative videolaryngostroboscopy, as well as established subjective and objective voice function diagnostics (Grade, Roughness, Breathiness [GRB] Scale; Voice Handicap Index; voice range profile; and acoustic-aerodynamic analysis).Results: In the pretreated VF with no or minimal lamina propria remaining, the exact placement of CaHA was not possible due to unpredictable propagation into the scarred tissue. The results showed an insufficient postoperative augmentation. Accordingly, the voice function did not improve. However, a significant increase of the vocal range from 6.2 ± 3.2 to 8.7 ± 3.9 semitones was observed in the speaking voice profile (P =.02). All other acoustic and aerodynamic parameters remained on the whole unchanged; the slight differences between pre- and postoperative findings were not significant.Conclusions: The application of CaHA in the surgically pretreated scarred larynx is not reliable to achieve a sufficient glottal closure and a satisfactory improvement of voice. Though CaHA is a welcome addition to our armamentarium against glottal insufficiency, the suitability for augmentation of scar tissue in the larynx must be considered carefully in each individual case.Level Of Evidence: 4 Laryngoscope, 127:1125-1130, 2017. [ABSTRACT FROM AUTHOR]

Conclusion: The resection of the medial and lateral pyriform sinus was associated with post-operative voice impairment after TOVS. Scar contracture around the cricoarytenoid joint lead to arytenoid fixation toward lateral position, and this wound healing process caused insufficient glottis closure. Although oncological and functional outcomes of TOVS was satisfactory, surgeons should mention the risk of post-operative voice impairment in pre-operative counseling. Objectives: Transoral surgery is a minimally invasive treatment option for hypopharyngeal and supraglottic cancer. Post-operative vocal function was satisfactory in most cases, but in some cases vocal cord was fixed and occasionally voice impairment persists. Methods: Vocal function of 55 patients who underwent transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancers was evaluated by the GRBAS perceptive scale, aerodynamic tests and acoustic analyses, and the Voice Handicap Index questionnaire. The risk factors for voice impairment were identified. Results: Voice impairment (G score ≧2) was found in 16 cases (29.1%). Univariate analysis revealed that the resection of medial and lateral pyriform sinus (p =.0018) and neck dissection (p =.0421) were associated with post-operative voice impairment. Multivariate analysis revealed that the resection of medial and lateral pyriform sinus (p =.0021) was associated with post-operative voice impairment. [ABSTRACT FROM AUTHOR]

Summary Objectives The Transsexual Voice Questionnaire (TVQ MtF ) is a population-specific self-report tool designed to capture the perceptions of male-to-female transsexual women (MtF women) regarding their vocal functioning and the voice-related impact on their everyday life. The aim of this study was to further the psychometric evaluation of the TVQ MtF by examining its construct validity and confirming its reliability. Study Design This is a prospective validity and reliability study. Methods One hundred fifty-one MtF women provided data for principal components analysis with oblimin rotation. Data from 133 of these participants were also analyzed to evaluate the internal consistency of the TVQ MtF . Results Principal components analysis identified a two-factor structure. The largest component (accounting for 51.99% of the variance) captured individuals' perceptions of their vocal functioning and included items related to the link between voice and gender identity. This component was labeled vocal functioning . The second component (5.82% of the variance) contained items that related to the impact of voice on the individual's participation in everyday life and was labeled social participation . Internal consistency was high (Cronbach's α = .97). Conclusions The findings support the construct validity of the TVQ MtF . Additionally, the high internal consistency of the TVQ MtF found in the current study confirms that the content of the TVQ MtF reliably measures the self-perceptions of MtF women regarding their voice. The current findings also support the clinical utility of the TVQ MtF providing a means of organizing TVQ MtF responses to inform the voice training process. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Recurrent respiratory papillomatosis (RRP) is a benign epithelial tumor that exhibits a high frequency of recurrence. This study assesses the vocal function after laser treatment for RRP, particularly in relation to the frequency of surgery.Study Design: Retrospective study.Methods: Thirty RRP patients who underwent laser surgery that controlled the tumor were included. Preoperative and postoperative Grade, Roughness, Breathiness, Asthenia, and Strain Scale, videostroboscopic findings, aerodynamic and acoustic parameters, and self-assessment questionnaires were measured and compared with an age- and sex-matched control group. Subsequently, to evaluate the association between postoperative voice quality and the number of surgeries, the patients were divided into three groups (group 1: single surgery, group 2: 2-5 surgeries, group3: >6 surgeries), and comparative multidimensional vocal assessments were performed.Results: The mean number of surgeries was 3.4 (range, 1-8). Although all patients exhibited poorer vocal function than the control group preoperatively, they showed improvement in postoperative subjective and objective parameters. However, four patients who underwent one surgery with relatively aggressive ablation exhibited vocal cord scarring and deteriorated objective parameters. All remaining patients showed voice quality that was on par with the control group. Subgroup analysis proved no association between post-therapeutic voice quality and the patient characteristics, including preoperative staging and the number of surgical treatments performed.Conclusions: RRP patients can achieve a close to normal voice with high satisfaction even after recurrent surgical treatment when ablation of a subepithelial lesion using sufficient laser energy is adequate.Level Of Evidence: 3b Laryngoscope, 127:679-684, 2017. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: This study was designed to assess the feasibility of the submucosal infusion technique combined with microflap dissection as a radical therapeutic and diagnostic option for precancerous laryngeal leukoplakia.Study Design: Retrospective study.Methods: Severe dysplasia or carcinoma in situ was diagnosed after phonomicrosurgical dissections in 25 patients with unilateral laryngeal leukoplakia. Of these, 15 patients preferred no additional surgery (observation group), whereas 10 patients underwent further laser subligamental cordectomy (additional surgery group). The relationship between the initial surgical margin and histopathological characteristics of additionally excised tissues was assessed to evaluate diagnostic reliability. Disease control was assessed to determine the oncologic efficacy of the therapeutic procedure. Comparative multidimensional vocal assessments were performed in both groups to evaluate functional advantages of one-stage excision.Results: After the initial phonomicrosurgical resection, three patients had residual dysplastic lesions near the vocal process and anterior commissure, whereas three other patients had lesions suspicious for recurrence. No postoperative malignant transformation was observed in any patient. Although well-preserved vocal function was observed in the observation group, vocal quality deteriorated shortly after laser surgery in the additional surgery group. Regarding acoustics, aerodynamics, and quality-of-life evaluations, statistically equivalent scores were observed between the observation and control groups, whereas scores were inferior in the additional surgery group than in the control group.Conclusions: Phonomicrosurgical resection may be a therapeutic option with oncologic efficacy against precancerous laryngeal leukoplakia. This radical management might achieve more satisfactory postoperative vocal function.Level Of Evidence: NA Laryngoscope, 127:153-158, 2017. [ABSTRACT FROM AUTHOR]

Many common voice disorders are chronic or recurring conditions that are likely to result from inefficient and/or abusive patterns of vocal behavior, referred to as vocal hyperfunction. The clinical management of hyperfunctional voice disorders would be greatly enhanced by the ability to monitor and quantify detrimental vocal behaviors during an individual’s activities of daily life. This paper provides an update on ongoing work that uses a miniature accelerometer on the neck surface below the larynx to collect a large set of ambulatory data on patients with hyperfunctional voice disorders (before and after treatment) and matched control subjects. Three types of analysis approaches are being employed in an effort to identify the best set of measures for differentiating among hyperfunctional and normal patterns of vocal behavior: 1) ambulatory measures of voice use that include vocal dose and voice quality correlates, 2) aerodynamic measures based on glottal airflow estimates extracted from the accelerometer signal using subject-specific vocal system models, and 3) classification based on machine learning and pattern recognition approaches that have been used successfully in analyzing long-term recordings of other physiological signals. Preliminary results demonstrate the potential for ambulatory voice monitoring to improve the diagnosis and treatment of common hyperfunctional voice disorders.

Background This study was designed to comparatively assess laryngeal function and quality of life (QOL) of patients after laser surgery (LS) or radiotherapy (RT) for early glottic cancer. Methods Sixty-four patients with T1 glottic cancer treated with RT or type II cordectomy underwent both subjective and objective vocal assessments. The LS group was divided into the following: (1) vaporization with defocused mode (laser surgery [LS]-Vap); and (2) excision with focused mode using lower power (LS-Ex). Results Auditory-perceptual evaluation and videostroboscopic images in the LS-Ex group worsened shortly after treatment and time-dependent recovery was quicker than in the LS-Vap group. The LS-Ex group showed equivalent posttherapeutic vocal function with the RT group by acoustics, aerodynamics, and self-assessment questionnaire analysis, whereas the LS-Vap group showed statistically significant worse function. Conclusion The multidimensional assessment showed that early glottic cancer could be successfully treated by either RT or LS-Ex with equivalent posttherapeutic laryngeal function and QOL. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1085-1090, 2016 [ABSTRACT FROM AUTHOR]

Background Dysphonia related to head and neck cancer is unique, and demands treatment tailored to its unique pathology. Activate exercises, breathing, counseling, laryngeal manipulation, oral resonance, vocal exercises, and elimination of habits (ABCLOVE) is an 8-week multimodality voice therapy program addressing vocal rehabilitation specifically for patients with head and neck cancer. Methods Twenty-nine patients with a history of head and neck cancer were enrolled in the ABCLOVE program and outcomes were retrospectively reviewed. Relative average pertubation, maximum phonation time (MPT), pitch range, Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), and Voice Handicap Index (VHI) were assessed. Results The pretreatment and posttreatment improvements in the relative average pertubation (1.86 vs 0.92), MPT (10.53 seconds vs 15.17 seconds), VHI (51.7 vs 29.9), and pitch range (168 Hz vs 244 Hz) were statistically significant ( p < .0001). The subjective CAPE-V ratings improved in all but 2 patients. Conclusion The ABCLOVE voice program provides clinicians with an effective and reproducible method for voice rehabilitation in patients with head and neck cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1810-E1813, 2016 [ABSTRACT FROM AUTHOR]