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Objective: Laryngeal function can be evaluated from multiple perspectives, including aerodynamic input, acoustic output, and mucosal wave vibratory characteristics. To determine the classifying power of each of these, we used a multilayer perceptron artificial neural network (ANN) to classify data as normal, glottic insufficiency, or tension asymmetry.
Study Design: Case series analyzing data obtained from excised larynges simulating different conditions.
Methods: Aerodynamic, acoustic, and videokymographic data were collected from excised canine larynges simulating normal, glottic insufficiency, and tension asymmetry. Classification of samples was performed using a multilayer perceptron ANN.
Results: A classification accuracy of 84% was achieved when including all parameters. Classification accuracy dropped below 75% when using only aerodynamic or acoustic parameters and below 65% when using only videokymographic parameters.
Conclusions: Samples were classified with the greatest accuracy when using a wide range of parameters. Decreased classification accuracies for individual groups of parameters demonstrate the importance of a comprehensive voice assessment when evaluating dysphonia.
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http://dx.doi.org/10.1002/lary.23549 | DOI Listing |
PLoS One
September 2025
Department of Otolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan.
Glottic insufficiency results from impaired vocal fold contact, leading to a gap between the folds and manifesting as hoarseness and respiratory difficulties. Vocal folds injection is a commonly utilized therapeutic approach to rectify this gap by augmenting vocal folds volume; however, the optimal injectable material remains undetermined. Dedifferentiated fat cells (DFATs), derived from mature adipocytes, exhibit robust proliferative capacity and multipotency, establishing them as potential candidates for treating glottic insufficiency.
View Article and Find Full Text PDFLaryngoscope
September 2025
UAB Voice Center, Department of Otolaryngology-Head and Neck Surgery, Heersink School of Medicine, Birmingham, Alabama, USA.
Objectives: To examine factors that direct decisions in the treatment of glottic insufficiency and propose a paradigm that may assist in treatment decision-making in glottic insufficiency.
Methods: A retrospective chart review was completed of 73 patients with vocal fold atrophy, presbyphonia, or vocal fold motion impairment, including diagnosis, Voice Handicap Index-10 (VHI-10), Voice Problem Impact Scales (VPIS), Glottal Function Index (GFI), Eating Assessment Tool-10 (EAT-10), Consensus Auditory Perceptual Analysis of Voice (CAPE-V), glottal gap size, stimulability, treatment decisions, and outcomes. Univariate and multivariate logistic regression analyses were performed to identify which variables predicted initial treatment recommendation.
Otolaryngol Head Neck Surg
August 2025
Department of Otolaryngology, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Objective: Injection laryngoplasty (IL) is performed to correct glottic insufficiency. There has been a purported shift away from operative techniques in favor of awake, in-office procedures, but no studies comparing utilization include updated current procedural terminology (CPT) coding. We analyzed the usage of operative versus awake injections CPT codes over 2 decades, recognizing that these encompass a broad array of injection procedures.
View Article and Find Full Text PDFJ Voice
August 2025
Division of Otolaryngology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts.
Objectives: It remains controversial as to whether or not improving glottic insufficiency contributes to voice handicap improvement in patients with Parkinson's disease (PD). In addition, the existing literature is sparse and not always objective in its primary outcome measures. This case series' objective is to add to the existing literature by evaluating Voice Handicap Index-10 (VHI) changes in patients with both age-related true vocal fold atrophy and PD who underwent vocal fold injection augmentation with a temporary material.
View Article and Find Full Text PDFJ Voice
August 2025
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Boston, MA; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA. Electronic address:
Introduction: Silk-hyaluronic acid (silk-HA), a true vocal fold (TVF) augmentation material used in humans since July 2020 for correcting glottic insufficiency, has demonstrated long-term, durable results over 12 months after injection. Collagen ingrowth and fibrosis replacing the silk-HA scaffold over approximately 18 months are expected to provide the durable effect. Outcomes and observations from patients presenting with follow-up periods greater than 3 years as well as patients who needed additional silk augmentation but were delayed more than 18 months in getting their "touch up" procedure are presented.
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