Patient-Reported Outcomes after False Vocal Folds Injections for Adductor Spasmodic Dysphonia.

Objectives: The primary objective of this study is to investigate if false vocal folds (FVF) or simultaneous FVF with thyroarytenoid (FVF+TA) Botox® injections achieve comparable treatment effects to standard TA injections. This study also aims to determine how patient-reported outcomes contribute to the transition to, and continuation of, FVF or FVF+TA injections.

Methods: Retrospective chart review was performed for all patients receiving Botox® for adductor spasmodic dysphonia at a laryngology practice between 2005 and 2018.

Laryngeal Cancer Screening During Flexible Video Laryngoscopy Using Large Computer Vision Models.

Objective: Develop an artificial intelligence assisted computer vision model to screen for laryngeal cancer during flexible laryngoscopy.

Methods: Using laryngeal images and flexible laryngoscopy video recordings, we developed computer vision models to classify video frames for usability and cancer screening. A separate model segments any identified lesions on the frames.

Computational fluid dynamics model of laryngotracheal stenosis and correlation to pulmonary function measures.

3D models of airway lumens were created from CT scans of 19 patients with laryngotracheal stenosis. Computational fluid dynamics (CFD) simulations were completed for each, and results were compared to measured peak inspiratory flow rate, grade of lumen constriction, and measures of airway geometry. Results demonstrate flow resistance and shear stress correlate with degree of lumen constriction and absolute cross-sectional area as well as flow rate.

Investigation of Vocal Bifurcations and Voice Patterns Induced by Asymmetry of Pathological Vocal Folds.

Purpose: Vocal fold asymmetry creates irregular entrainments and modulations in voice, which may lead to rough perceptual quality. The presence of asymmetry can also cause mid-phonation bifurcations where a small change in the phonatory system causes a drastic change in vibration pattern, resulting in transitions in and out of rough voice. This study surveys sustained phonation recordings of speakers with the diagnoses of vocal fold polyp or unilateral vocal fold paralysis to investigate the resulting voice patterns.

Harmonics-to-noise ratio estimation with deterministically time-varying harmonic model for pathological voice signals.

The harmonics-to-noise ratio (HNR) and other spectral noise parameters are important in clinical objective voice assessment as they could indicate the presence of nonharmonic phenomena, which are tied to the perception of hoarseness or breathiness. Existing HNR estimators are built on the voice signals to be nearly periodic (fixed over a short period), although voice pathology could induce involuntary slow modulation to void this assumption. This paper proposes the use of a deterministically time-varying harmonic model to improve the HNR measurements.

A modular surgical simulator for microlaryngoscopy using standard instruments and the carbon dioxide laser.

Objective: Build a microlaryngoscopy surgical simulator for endoscopic laryngeal surgery using standard microsurgical instruments and a CO laser.

Study Design: Anatomical modeling, CAD design and 3D printed manufacturing.

Subjects And Methods: We created a modular design for a microlaryngoscopy simulator in CAD software.

Predicting Need for Surgery in Recurrent Laryngotracheal Stenosis Using Changes in Spirometry.

Objectives/hypothesis: We sought to identify changes that occur in spirometric values between surgical interventions in patients with recurrent laryngotracheal stenosis and assess the utility of tracking those changes in predicting the need to return to surgery.

Methods: This is a retrospective, case-control study of laryngotracheal stenosis. Charts from a 10 year period were reviewed, and 80 patients were identified with recurrent laryngotracheal stenosis and serial spirometry.

Optical Biopsy: Automated Classification of Airway Endoscopic Findings Using a Convolutional Neural Network.

Objectives/hypothesis: Create an autonomous computational system to classify endoscopy findings.

Study Design: Computational analysis of vocal fold images at an academic, tertiary-care laryngology practice.

Methods: A series of normal and abnormal vocal fold images were obtained from the image database of an academic tertiary care laryngology practice.

Voice Outcomes Following Multiple Surgeries for Recurrent Respiratory Papillomatosis.

Objectives: Recurrent Respiratory Papillomatosis (RRP) is a rare disease caused by the human papilloma virus that presents as warty, exophytic growths in the upper airway. RRP in the larynx can lead to severe airway obstruction and voice changes. It is clinically known that patients with RRP frequently experience dysphonia.

Ectopic parathyroid adenoma in the pyriform sinus.

Background: Ectopic parathyroid glands may complicate the surgical approach to primary hyperparathyroidism. We describe a rare ectopic parathyroid location, the pyriform sinus.

Methods: Three patients, 2 after prior unsuccessful parathyroid exploration, were found to have ectopic parathyroid adenomas in the pyriform sinus.

Simulators for Laryngeal and Airway Surgery.

There is growing support from the Accreditation Council for Graduate Medical Education and the Joint Commission of Accreditation of Health Care Organizations for a competency-based evaluation of medical and surgical performance. This is part of the quality movement in health care whereby the Centers for Medicare and Medicaid Services and third-party insurance companies have begun to link reimbursement incentives to positive surgical outcomes. Laryngeal and airway surgery require precise technique and significant mastered skill that can be difficult to obtain during otolaryngology residency training.

Association of asthma with clinically aggressive recurrent respiratory papillomatosis.

Objective: To determine whether there is an association between the presence of asthma and a clinically aggressive disease course in patients with recurrent respiratory papillomatosis (RRP).

Design: Retrospective multi-institutional cohort study (level III evidence).

Setting: Two academic medical centers in the southeastern United States.