Changes in voice quality after a Pure Tone Stimulation (PTS) Program.

Background: Auditory feedback allows individuals to monitor their vocal characteristics and adjust to maintain optimal voice quality. One type of auditory stimulation for conversational voice training/therapy is pure tone stimulation. This technique presents binaural auditory stimuli consisting of pure tones separated by half-step intervals to modify the fundamental frequency of the speaking voice and expand the vocal range.

Screening Voice Disorders: Acoustic Voice Quality Index, Cepstral Peak Prominence, and Machine Learning.

Introduction: The Acoustic Voice Quality Index (AVQI) and Smoothed Cepstral Peak Prominence (CPPs) have been reported to effectively support the assessment of voice quality in persons seeking voice care across many languages. This study aimed to evaluate the diagnostic accuracy of these two measures in detecting voice disorders in American English speakers, comparing their performance to machine learning (ML) models.

Methods: This retrospective study included a cohort of 187 participants: 138 patients with clinically diagnosed voice disorders and 49 vocally healthy individuals.

Revisiting the etiology and clinical characteristics of hemorrhagic polyps of the vocal fold.

Objective: Benign phonotraumatic lesions of the vocal folds (BVFLs) are typically seen in younger female patients with high vocal loads. Hemorrhagic polyps (HPs) do not fit the classic paradigm of most BVFLs, as they tend to occur in an older population, have a male predominance, and report to result from a vocal accident. We present one of the largest cohorts of HPs, to reexamine their etiology and clinical features.

Clinical Utility and Validation of the Acoustic Voice Quality and Acoustic Breathiness Indexes for Voice Disorder Assessment in English Speakers.

Background: While several acoustic voice metrics are available for clinical voice assessment, there remains a significant need for reliable and ecologically valid tools. The Acoustic Voice Quality Index version 03.01 (AVQI-3) and Acoustic Breathiness Index (ABI) hold potential due to their comprehensive assessment approach, incorporating diverse voice aspects.

Flexible Versus Rigid Laryngoscopy: A Prospective, Blinded Comparison of Image Quality.

Objective: To compare flexible distal-chip laryngoscopy (FDL) and rigid telescopic laryngoscopy (RTL) in image quality and diagnostic ability.

Study Design: Prospective cohort study; blinded comparison.

Methods: Eighteen normal adult subjects were recruited to undergo both FDL and RTL and normalized videos were recorded.

Hyoid Bone Syndrome and Dysphonia: Can Throat Pain Affect the Voice?

Objectives/hypothesis: To investigate the relationship of throat pain and dysphonia.

Study Design: Prospective cohort study.

Methods: Forty-five subjects presenting with hyoid bone syndrome (HBS) and dysphonia were asked to rate their pain on a numerical rating scale and complete the 10-item Voice-Related Quality of Life (V-RQOL) questionnaire prior to and at 1-week follow-up after treatment with triamcinolone injection into the attachments to the affected greater cornu(s).

Telemedicine and the Interdisciplinary Clinic Model: During the COVID-19 Pandemic and Beyond.

The emergence of the novel coronavirus disease 2019 (COVID-19) and the subsequent need for physical distancing have necessitated a swift change in health care delivery. Prior to the COVID-19 outbreak, many institutions utilized an interdisciplinary clinic model including both a laryngologist and a speech-language pathologist for the evaluation of patients with voice, swallowing, and upper airway disorders. To improve access, many providers are pursuing the use of interdisciplinary telemedicine to provide individualized patient-centered care while allowing for physical distancing.

The Effect of Unilateral Hearing Protection on Vocal Intensity With Varying Degrees of Background Noise.

Introduction: The Lombard effect (LE) is a phenomenon in which speakers adjust their vocal production by raising the volume in noisy environments. As a result, the LE can create problems of vocal strain, fatigue and potential injury.

Objectives: This study aims to examine the difference in vocal intensity output in subjects wearing unilateral hearing protection versus no hearing protection in the presence of background noise.

The Art of Caring for the Professional Singer.

Training in care of the voice for the general otolaryngologist has improved with the presence of more fellowship-trained laryngologists within academic training programs. However, preparation for caring for the professional singer goes beyond the basic understanding of voice evaluation, laryngeal imaging, and microlaryngeal surgery. The otolaryngologist must have a deeper understanding of the demands, vocabulary, psyche, and economics of the professional singer to provide optimal care.

Reproducibility of Voice Parameters: The Effect of Room Acoustics and Microphones.

Introduction: Computer analysis of voice recordings is an integral part of the evaluation and management of voice disorders. In many practices, voice samples are taken in rooms that are not sound attenuated and/or sound-proofed; further, the technology used is rarely consistent. This will likely affect the recordings, and therefore, their analyses.

Comparison of Pitch Strength With Perceptual and Other Acoustic Metric Outcome Measures Following Medialization Laryngoplasty.

Introduction: The diagnoses of voice disorders, as well as treatment outcomes, are often tracked using visual (eg, stroboscopic images), auditory (eg, perceptual ratings), objective (eg, from acoustic or aerodynamic signals), and patient report (eg, Voice Handicap Index and Voice-Related Quality of Life) measures. However, many of these measures are known to have low to moderate sensitivity and specificity for detecting changes in vocal characteristics, including vocal quality.

Objective: The objective of this study was to compare changes in estimated pitch strength (PS) with other conventionally used acoustic measures based on the cepstral peak prominence (smoothed cepstral peak prominence, cepstral spectral index of dysphonia, and acoustic voice quality index), and clinical judgments of voice quality (GRBAS [grade, roughness, breathiness, asthenia, strain] scale) following laryngeal framework surgery.

Pitch Strength as an Outcome Measure for Treatment of Dysphonia.

Background: Measurement of treatment outcomes is critical for the spectrum of voice treatments (ie, surgical, behavioral, or pharmacological). Outcome measures typically include visual (eg, stroboscopic data), auditory (eg, Consensus Auditory-Perceptual Evaluation of Voice; Grade, Roughness, Breathiness, Asthenia, Strain), and objective correlates of vocal fold vibratory characteristics, such as acoustic signals (eg, harmonics-to-noise ratio, cepstral peak prominence) or patient self-reported questionnaires (eg, Voice Handicap Index, Voice-Related Quality of Life). Subjective measures often show high variability, whereas most acoustic measures of voice are only valid for signals where some degree of periodicity can be assumed.

Autoimmune swallowing disorders.

Purpose Of Review: Dysphagia can be the presenting symptom of autoimmune disease. The otolaryngologist should be familiar with and consider these disorders when assessing the patient with swallowing difficulties.

Recent Findings: The present review gives a brief overview of Sjogren's syndrome, granulomatosis with polyangiitis, pemphigus and pemphigoid, rheumatoid arthritis, systemic lupus erythematosus, scleroderma and inflammatory myopathies, and how they affect swallowing.

Prospective multi-institutional transnasal esophagoscopy: Predictors of a change in management.

Objectives/hypothesis: To evaluate clinical indications and endoscopic findings for patients undergoing transnasal esophagoscopy (TNE).

Study Design: Prospective, multi-institutional, observational cohort study at four tertiary centers.

Methods: Demographics, reflux finding score, reflux symptom index, Eating Assessment Tool (EAT-10) scores, clinical indications, and endoscopic findings were compared among patients whose TNE findings resulted in a changes in management (FCIM), defined as a referral, new medication, or surgery recommendation.

Dysphagia due to inclusion body myositis: case presentation and review of the literature.

Objective: This report aimed to present a case of inclusion body myositis presenting with dysphagia and to review the literature.

Methods: Case report and literature review.

Results: Inclusion body myositis is a chronic progressive acquired myopathy, uniquely distinguished by its selective muscle involvement, normal or moderately elevated muscle enzyme concentrations, and a progressive corticosteroid-resistant course.

The role of laryngoscopy in the diagnosis of spasmodic dysphonia.

Importance: Spasmodic dysphonia (SD) can be difficult to diagnose, and patients often see multiple physicians for many years before diagnosis. Improving the speed of diagnosis for individuals with SD may decrease the time to treatment and improve patient quality of life more quickly.

Objective: To assess whether the diagnosis of SD can be accurately predicted through auditory cues alone without the assistance of visual cues offered by laryngoscopic examination.

Spindle cell carcinoma of the larynx presenting as a vocal fold cyst.

Spindle cell carcinoma (SPCC) is a rare, malignant variant of squamous cell carcinoma (SCC), which shows biphasic proliferation of the conventional SCC component and malignant spindle shape cells with sarcomatous appearance. We present two cases of SPCC of the true vocal fold that presented as a benign appearing subepithelial mass. We discuss the patient presentation, voice assessment, surgical treatment, and a review of the literature.

Globus pharyngeus: effectiveness of treatment with proton pump inhibitors and gabapentin.

Objectives: This study was performed to investigate the effectiveness of treatment of globus pharyngeus with proton pump inhibitors, gabapentin, or both.

Methods: The subjects all presented with globus pharyngeus during the years 2006 to 2011. The inclusion criteria included a chief (primary) complaint of globus pharyngeus; a trial of proton pump inhibitor therapy for at least 2 months and/or a trial of gabapentin for at least 2 weeks; and at least 1 follow-up visit.

Analysis of supraglottic activity during vocalization in healthy singers.

Objectives/hypothesis: The present study aims to evaluate the degree of anterior-posterior and medial supraglottic laryngeal compression in healthy singers of different voice classifications while singing different pitches, loudness, and phonatory tasks.

Study Design: Prospective study.

Methods: Thirty-six classically trained singers (11 sopranos, 11 mezzo-sopranos, six tenors, and eight baritones) with at least 5 years of voice training and absence of any voice pathology within the past year were included.

Hyoid bone syndrome: a retrospective review of 84 patients treated with triamcinolone acetonide injections.

Objectives: We present a cohort of patients with hyoid bone syndrome who were treated with injections of triamcinolone acetonide (40 mg/mL), in order to raise awareness of this condition, validate its existence, and demonstrate the efficacy of this treatment.

Methods: We performed a retrospective chart review of patients who were given a diagnosis of and treated for hyoid bone syndrome by the senior author (A.D.

Influence of emotional expression, loudness, and gender on the acoustic parameters of vibrato in classical singers.

Objectives: Vibrato is considered one of the most essential characteristics of the classical singing voice. Vibrato can be acoustically described by the rate, extent, onset, and regularity. The aim of this study was to determine the influence of emotional expression on acoustic parameters of vibrato in classically trained singers.

The use of the mobile voice laboratory in the operating room during type I thyroplasty with Gore-Tex(®).

Introduction And Objective: The purposes of this study are to demonstrate the use of the mobile voice lab in type I thyroplasty with Gore-Tex(®) using analysis of spectrogram and fundamental frequency in the operating room, and also to show how to do this procedure.

Methods: Voice samples were recorded in the operating room immediately before and during type I thyroplasty. Six-week postoperative samples were also taken in the voice laboratory.