Prevalence of Long-Term Dysphagia in Head and Neck Cancer Survivors Not Receiving Dysphagia Treatment.

Objective: In head and neck cancer (HNC) survivors not actively receiving dysphagia care, long-term dysphagia prevalence, dysphagia-related complications, and quality of life outcomes remain poorly understood. Understanding these outcomes is critical for creating effective HNC survivorship programs.

Methods: HNC survivors who completed cancer treatment > 2 years prior who had not undergone a swallow evaluation or therapy for > 1 year completed the MD Anderson Dysphagia Inventory (MDADI) and reported dysphagia-related complications.

Simultaneous Upper Airway Dilation and Ventilation With the Trachealator: Technical Pearls and Pitfalls.

Objectives: Balloon dilation is a method for treating laryngotracheal stenosis. This traditionally necessitates temporary airway occlusion, which requires apnea, carries the risk of barotrauma, and limits the duration of dilation. The Trachealator, a non-occlusive balloon, is designed to facilitate uninterrupted ventilation during dilation.

Swallowing Function Outcomes in Head and Neck Cancer Survivors Followed by a Long-Term Dysphagia Surveillance Protocol.

Background: This study aimed to evaluate swallow outcomes in head and neck cancer (HNC) survivors enrolled in a long-term dysphagia surveillance protocol following curative intent radiotherapy (RT).

Methods: We conducted a retrospective review of videofluoroscopic swallow studies from 2015 to 2023 in HNC patients treated with RT. Swallow kinematics and function were assessed at baseline, 0-1, 1-2, 2-5, and 5+ years post-RT.

Correlation of the VFSS Esophageal Screen to High-Resolution Esophageal Manometry.

Objective: The videofluoroscopic swallow study (VFSS) is an evaluation of the anatomy and physiology of swallowing, and often includes a screening evaluation of the esophagus. How the esophageal screen translates to esophageal pathology remains unknown. The purpose of this study was to determine if abnormal esophageal clearance (EC) on VFSS correlates with esophageal function on high-resolution esophageal manometry (HREM).

The Efficacy of Outpatient Swallowing Therapy: A Retrospective Longitudinal Cohort Study.

Oropharyngeal dysphagia is an independent predictor of poor outcomes in many health conditions and can be targeted directly through swallowing therapy. This study aims to explore the outcomes of outpatient swallowing therapy in clinical practice across a diverse cohort of patients. This was a retrospective, single-site longitudinal cohort study.

Effects of Intentional Register Instability During Onset of High-Intensity Phonation.

Objectives/hypothesis: This study investigated the effects of the "crack-sob" onset-a distinctive vocal technique combining a sob gesture with an intentional pitch break-on vocal fold function during high-intensity singing. We hypothesized that this onset would either decrease glottal adduction and increase vocal fold vibration stability or alternatively, show no measurable effects while still providing perceived benefits to singers.

Study Design: Prospective observational cohort study.

Third Proceedings of The North American Airway Collaborative (NoAAC): Consensus Statement on Trial Design for Airway Stenosis.

Importance: Airway stenosis is a rare but debilitating disorder that significantly degrades the quality of life in affected patients. Treatments are primarily surgical, and disease management lacks established medical therapies. The North American Airway Collaborative held its third symposium at The Johns Hopkins Hospital in Baltimore, Maryland, on April 15, 2024, focused on strategies to advance the care of these patients.

Follow-up Trends in Patients Undergoing Modified Wendler Glottoplasty.

Objectives: After modified Wendler glottoplasty (mWG), close follow-up with laryngologist and speech-language pathologist (SLP) is thought to be essential to achieve best outcomes. This study presents a case series of patients undergoing mWG at a single institution to identify factors associated with trends in post-operative follow-up.

Methods: Retrospective review of trans women patients who underwent mWG between March 2018 and July 2023 was performed.

Efficacy of Posterior Pharyngeal Wall Injection for Velopharyngeal Dysfunction in Adults.

Objective(s): Posterior pharyngeal wall (PPW) injection is often employed to treat velopharyngeal deficiency (VPD). We sought to analyze the impact of PPW injection on severity of dysphagia and dysphonia.

Methods: Retrospective chart review was conducted of patients undergoing PPW injection from 2018 to 2023 at a tertiary laryngology center.

Factors associated with adherence to swallowing therapy among patients diagnosed with oropharyngeal dysphagia.

Objective: The objective of this study is to assess disparities in adherence to swallowing therapy for clinically diagnosed oropharyngeal dysphagia (OD) patients.

Methods: Analysis was conducted on data from 600 patients with OD and confirmed impairments in swallowing safety and/or efficiency on a videofluoroscopic swallow study. Patients were classified based on their adherence to treatment sessions, defined as the number of swallow treatment sessions attended.

Vocal Health Assessment of Professional Performers Returning to the Stage After the COVID-19 Pandemic Shutdown.

Objectives/hypothesis: This study assessed the vocal health of performers returning to full-time performance after the COVID-19 pandemic shutdown and investigated how differences in voice usage, exposure to voice care professionals, and vocal pathology before and during the pandemic contributed to variability in self-perceived and instrumental vocal outcome measures.

Study Design: This was a prospective, case-control observational study conducted at a single outpatient site.

Methods: Twenty-two patients, 11 cases and 11 controls, were enrolled for the study.

A Large Cohort Analysis of Epiglottic Phenotypes and Pharyngeal Residue.

Objective: To describe the phenotypic characteristics of the epiglottis at rest and their impact on vallecular residue.

Methods: Videofluoroscopic studies (VFSS) were pooled from 2 Laryngology practices, and Image J was used to measure epiglottic anatomic features at rest. Studies were rated by the MBSImp and presence of vallecular residue following swallow of thin and puree boluses.

The Effectiveness of Ultraviolet Smart D60 in Reducing Contamination of Flexible Fiberoptic Laryngoscopes.

Objective: To compare the effectiveness of disinfection protocols utilizing a ultraviolet (UV) Smart D60 light system with Impelux™ technology with a standard Cidex ortho-phthalaldehyde (OPA) disinfection protocol for cleaning flexible fiberoptic laryngoscopes (FFLs).

Methods: Two hundred FFLs were tested for bacterial contamination after routine use, and another 200 FFLs were tested after disinfection with one of four methods: enzymatic detergent plus Cidex OPA (standard), enzymatic detergent plus UV Smart D60, microfiber cloth plus UV Smart D60, and nonsterile wipe plus UV Smart D60. Pre- and post-disinfection microbial burden levels and positive culture rates were compared using Kruskal-Wallis ANOVA and Fisher's two-sided exact, respectively.

Validation of a 3D-Printed Percutaneous Injection Laryngoplasty Simulator: A Randomized Controlled Trial.

Objective: Simulation may be a valuable tool in training laryngology office procedures on unsedated patients. However, no studies have examined whether existing awake procedure simulators improve trainee performance in laryngology. Our objective was to evaluate the transfer validity of a previously published 3D-printed laryngeal simulator in improving percutaneous injection laryngoplasty (PIL) competency compared with conventional educational materials with a single-blinded randomized controlled trial.

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.

Paralysis Versus Non-Paralysis Anesthesia for Operative Laryngoscopy: A Randomized Controlled Trial.

Objective: To compare outcomes between two standard-of-care anesthesia regimens for operative laryngoscopy: general anesthesia with a neuromuscular blocking agent (NMBA) versus remifentanil and propofol (non-NMBA).

Methods: This was a prospective, single-blinded, randomized controlled trial at a tertiary care center. Patients were randomized to either anesthesia using rocuronium (NMBA) or with remifentanil/propofol infusion alone (non-NMBA).

Perilaryngeal-Cranial Functional Muscle Network Differentiates Vocal Tasks: A Multi-Channel sEMG Approach.

Objective: Objective evaluation of physiological responses using non-invasive methods for the assessment of vocal performance and voice disorders has attracted great interest. This paper, for the first time, aims to implement and evaluate perilaryngeal-cranial functional muscle networks. The study investigates the variations in topographical characteristics of the network and the corresponding ability to differentiate vocal tasks.

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.

Classification of tracheal stenosis in children based on computational aerodynamics.

Tracheal stenosis is a health condition in which local narrowing of the upper trachea can cause breathing difficulties and increased incidence of infection, among other symptoms. Occurring most commonly due to intubation of infants, tracheal stenosis often requires corrective surgery. It is challenging to determine the most effective surgical strategy for a given patient as current clinical methods used to assess tracheal stenosis are simplistic and subjective, and are not rigorously based on aerodynamic considerations.

Use of modified barium swallow study to measure posterior airway space in obstructive sleep apnea.

Conclusion Measurement of the posterior airway space (PAS) using modified barium swallow (MBS) appears to correlate well with CT imaging. This data suggests MBS may be a low-cost alternative imaging modality to assess obstructive sleep apnea patients. Objectives Obstructive sleep apnea research has focused on imaging modalities that supplement polysomnography in evaluation of potential sites of airway obstruction.