Search Our Scientific Publications & Authors

J Formos Med Assoc 2021 May 24. Epub 2021 May 24.

Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Special Education, University of Taipei, Taipei, Taiwan; Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan. Electronic address:

Background/purpose: Voice therapy is frequently recommended as the first-line treatment for benign voice disorders. This study investigated the clinical effectiveness of voice therapy and the prognostic factors of treatment outcomes.

Methods: We recruited 103 consecutive patients with voice disorders, namely vocal nodules, polyps, and muscle tension dysphonia (MTD), from September 2014 to July 2016. Read More

Eur Arch Otorhinolaryngol 2021 Apr 23. Epub 2021 Apr 23.

Department of Otorhinolaryngology, College of Health Sciences, University of Ilorin, University of Ilorin Teaching Hospital, PMB 1515, Ilorin, 240003, Kwara, Nigeria.

Background: Flexible fibreoptic laryngoscopy (FFL) is a technique of laryngeal visualization. The instrument (flexible laryngoscope) is relatively scarce in resource challenged countries. Where available, it is a useful compliment to the armamentarium of clinical tools at the disposal of the otolaryngologist. Read More

Laryngoscope 2021 Apr 9. Epub 2021 Apr 9.

The Sean Parker Institute for the Voice, Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medicine, New York, New York, USA.

Objectives/hypothesis: To examine patterns of recurrence of benign phonotraumatic vocal fold lesions over time for insights into pathophysiology.

Study Design: Case series with mathematical modeling.

Methods: Medical records and stroboscopic exams of adults who underwent microlaryngoscopic resection of phonotraumatic vocal fold lesions over a 13-year period were reviewed for time to recurrence after surgery. Read More

J Voice 2021 Mar 8. Epub 2021 Mar 8.

Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan; Department of Special Education, University Of Taipei, Taipei, Taiwan. Electronic address:

Objectives: Current treatments for benign vocal lesions consist mainly voice therapy and phonomicrosurgery. However, these options are not always suitable for professional voice users because of their tight performance schedule and limited time for voice rest. This study investigated vocal fold steroid injection (VFSI) as an alternative treatment. Read More

J Voice 2021 Jan 19. Epub 2021 Jan 19.

Department of Otolaryngology Head and Neck Surgery, Istanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey. Electronic address:

Background: The aim of the study was comparing the diagnostic role of the white light (WL) endoscopy, video laryngostroboscopy (VLS), and narrow-band imaging (NBI) in the evaluation of the benign vocal fold lesions.

Material And Methods: From March 2018 to June 2019, a total of 118 cases were enrolled in this study. Ninety-eight patients were suspected with vocal fold nodules, cysts, polyps, and sulcus vocalis and 20 patients without a history of dysphonia. Read More

Am J Speech Lang Pathol 2021 01 20;30(1):199-209. Epub 2021 Jan 20.

Massachusetts General Hospital, Boston.

Purpose Previous ambulatory voice monitoring studies have included many singers and have combined speech and singing in the analyses. This study applied a singing classifier to the ambulatory recordings of singers with phonotrauma and healthy controls to determine if analyzing speech and singing separately would reveal voice use differences that could provide new insights into the etiology and pathophysiology of phonotrauma in this at-risk population. Method Forty-two female singers with phonotrauma (vocal fold nodules or polyps) and 42 healthy matched controls were monitored using an ambulatory voice monitor. Read More

Laryngoscope 2021 Jan 9. Epub 2021 Jan 9.

Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.

Objectives/hypothesis: Vertical locations of vocal fold mucosal lesions (VFMLs) vary along the free edge. As the vertical contact area of vocal folds (VFs) depends on the vocal register, lesions may occur in the contact area of more frequently used vocal registers. This study investigated the cause of location variations by comparing the vertical sites of VFMLs in singers of both sexes with different music genres. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2021 May 12;138(3):169-175. Epub 2020 Nov 12.

Service ORL et chirurgie cervico-faciale, CHU de Bordeaux-Pellegrin, place Amélie Rabat-Léon, 33000 Bordeaux, France.

Objectives: There are emerging reports of the effectiveness of in-office awake vocal-fold corticosteroid injection in the treatment of exudative vocal-fold lesions. The aim of this study was to review this therapy and specify indications, practical modalities and outcomes.

Study Design: Systematic review of the literature without meta-analysis. Read More

Acta Otorhinolaryngol Ital 2020 Aug;40(4):262-269

Teleaudiology and Screening Department, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland.

J Voice 2020 Oct 12. Epub 2020 Oct 12.

National Institute for Research in Phoniatrics, University of Pisa, Pisa, Italy.

Objectives: To confirm the data reported in our previous studies on the analysis of the variability of the electroglottographic signal in the pathological voice; to evaluate possible differences in variability between organic and functional pathologies; to identify any distinctive/typical EGG patterns for these pathologies.

Methods: One hundred twenty-five subjects were enrolled (36 euphonic and 89 pathological: 24 functional dysphonia, 21 bilateral vocal nodules, 23 unilateral polyps and 21 unilateral cysts). All subjects were studied with videolaryngostroboscopy, spectrographic analysis of voice and electroglottography (EGG). Read More

J Voice 2020 Oct 6. Epub 2020 Oct 6.

Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: Five dimensions of voice assessment are considered as visual evaluation, videostroboscopy, acoustic, aerodynamic, patient-based, and auditory-perceptual. Auditory-perceptual voice assessment scales are the standard scales for clinicians to document voice therapy outcomes in dysphonic patients. The primary objective of the present study was to investigate the construct and discriminant validities of the Persian Version of the CAPE-V (ATSHA). Read More

J Voice 2020 Sep 28. Epub 2020 Sep 28.

Institute of Neurosciences, University of Louvain, Brussels, Belgium. Electronic address:

Mechanical impact stress on the vocal fold surface, particularly when excessive, has been postulated to cause the so-called phonotraumatic tissue lesions, such as nodules and polyps. The collision stress between the vocal folds depends on the vocal fold velocity at the time of impact. Hence this vocal fold collision speed is a relevant parameter when considering biomechanical economy of phonation, especially in voice professionals needing a louder voice than normal. Read More

Am J Case Rep 2020 Jul 3;21:e920528. Epub 2020 Jul 3.

Ear, Nose and Throat (ENT) Unit, Department of General and Specialized Surgery, AOU University of Campania "Luigi Vanvitelli", Napoli, Italy.

BACKGROUND Lipomas, the most common soft tissue tumors, represent almost half of all benign mesenchymal neoplasms and are characterized by the absence of symptoms. However, if they grow in a laryngeal site, they can cause dyspnea and dysphonia which represents one of the major symptoms of benign laryngeal diseases (such as polyps or nodules); these symptoms are often the first symptom of neoplastic diseases. CASE REPORT We present a case of a 28-year-old female patient with a rounded pseudocyst neoformation located in the left aryepiglottic fold that partially hid the homolateral vocal cord and limited its mobility. Read More

J Speech Lang Hear Res 2020 07 24;63(7):2132-2140. Epub 2020 Jun 24.

Department of Otolaryngology-Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.

Purpose Previous studies have reported that voice therapy via telepractice is useful for patients with nodules and muscle tension dysphonia. Nevertheless, telepractice for elderly patients with voice disorders has not yet been investigated. We conducted this study to examine the hypothesis that voice therapy via telepractice is not inferior to conventional voice therapy. Read More

Radiographics 2020 May-Jun;40(3):775-790

From the Department of Imaging, University College London Hospitals, London, England (T.B., S.M.); Department of Otorhinolaryngology, Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, Kings Cross, London WC1X 8DA, England (V.M.T.); and Serviço de Radiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal (M.H.).

Although US is one of the most used modalities for head and neck imaging, its use in the diagnosis of laryngeal abnormalities is much less widespread. The standard assessment of laryngeal abnormalities currently involves direct laryngoscopy and cross-sectional imaging (either CT or MRI) but rarely US. US is readily available, noninvasive, and radiation free, and it allows real-time imaging (with video for dynamic assessment), higher resolution than that of cross-sectional imaging, and the performance of targeted fine needle aspiration cytology or biopsy. Read More

Eur Arch Otorhinolaryngol 2020 Sep 30;277(9):2493-2500. Epub 2020 Apr 30.

Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Pasterova 2, 11000, Belgrade, Serbia.

Purpose: To compare the prevalence and severity of depression and anxiety among patients with vocal fold (VF) nodules, polyps and edema. At the same time the aim was to analyse association between severity of distress and the level of vocal handicap as well as to identify other factors related to severity of depression and anxiety in these patients.

Methods: To all participants were given five questionnaires: (1) questionnaire on socio-demographic and some other characteristics of patient; (2) Beck's Depression Inventory (BDI); (3) State-Trait Anxiety Inventory (STAI) 1 (State Anxiety); (4) STAI 2 (Trait Anxiety); and (5) Voice Handicap Index (VHI)-10. Read More

Laryngoscope 2020 Apr 28. Epub 2020 Apr 28.

Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A.

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. Read More

J Voice 2020 Mar 23. Epub 2020 Mar 23.

Brazilian Red Cross Hospital, Branch of Paraná, Lauro Grein Study Center, Curitiba, Paraná, Brazil.

Introduction: The examination of the larynx with indirect visualization is one of a series of steps in otorhinolaryngological evaluation. In the past this exam was performed more commonly with mirrors and headlights, but for at least the last four decades physicians have resorted to assessing the laryngopharynx with both rigid and fiberoptic instruments. The rigid 70° laryngoscope is the most used in our practice, its main drawback being the time-consuming resterilization process needed between scope usages in different patients. Read More

J Speech Lang Hear Res 2020 02 14;63(2):361-371. Epub 2020 Feb 14.

Department of Speech, Language & Hearing Sciences, Boston University, MA.

Purpose Relative fundamental frequency (RFF) is an acoustic measure that is sensitive to functional voice differences in adults. The aim of the current study was to evaluate RFF in children, as there are known structural and functional differences between the pediatric and adult vocal mechanisms. Method RFF was analyzed in 28 children with vocal fold nodules (CwVN, = 9. Read More

Laryngoscope 2020 11 18;130(11):E686-E693. Epub 2020 Feb 18.

Department of Otorhinolaryngology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.

Objectives/hypothesis: To develop a deep-learning-based computer-aided diagnosis system for distinguishing laryngeal neoplasms (benign, precancerous lesions, and cancer) and improve the clinician-based accuracy of diagnostic assessments of laryngoscopy findings.

Study Design: Retrospective study.

Methods: A total of 24,667 laryngoscopy images (normal, vocal nodule, polyps, leukoplakia and malignancy) were collected to develop and test a convolutional neural network (CNN)-based classifier. Read More

J Speech Lang Hear Res 2020 02 29;63(2):372-384. Epub 2020 Jan 29.

Massachusetts General Hospital, Boston.

Purpose Previous work using ambulatory voice recordings has shown no differences in average vocal behavior between patients with phonotraumatic vocal hyperfunction and matched controls. This study used larger groups to replicate these results and expanded the analysis to include distributional characteristics of ambulatory voice use and measures indicative of glottal closure. Method Subjects included 180 adult women: 90 diagnosed with vocal fold nodules or polyps and 90 age-, sex-, and occupation-matched controls with no history of voice disorders. Read More

Otolaryngol Head Neck Surg 2020 Mar 21;162(3):322-325. Epub 2020 Jan 21.

Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Objective: The objective of this study was to determine the prevalence of benign vocal fold lesions (BVFLs) in patients with chronic cough over a 1-year period.

Study Design: Case series with chart review.

Setting: Tertiary academic medical center. Read More

J Med Case Rep 2020 Jan 4;14(1). Epub 2020 Jan 4.

Department of Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Background: Among the most common benign laryngeal lesions are vocal nodules and polyps. Their etiology is related to vocal abuse. Gastroesophageal reflux disease is a common condition presenting with a broad spectrum of symptoms, among which are extraesophageal manifestations such as laryngeal polyps. Read More

J Voice 2021 May 17;35(3):411-417. Epub 2019 Dec 17.

Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts.

Objective: Cepstrum-based voice measures, such as smoothed cepstral peak prominence (CPPS), are influenced by voice sound pressure level (SPL) in vocally healthy adults. Since it is unclear if similar effects hold in voice disordered adults and how these interact with natural fundamental frequency (f) changes, this study examines voice SPL and f effects on CPPS in women with vocal hyperfunction and vocally healthy controls.

Study Design: Retrospective matched case-control study. Read More

Indian J Otolaryngol Head Neck Surg 2019 Oct 19;71(Suppl 1):327-332. Epub 2018 Mar 19.

Department of ENT, SMS Medical College, Jaipur, Rajasthan 302004 India.

Benign vocal cord mass lesions are common causes of dysphonia which are often surgically correctable. They include lesions like vocal polyps, vocal cysts, vocal nodules and Reinke's edema. A prospective study of 30 patients was carried out at SMS medical college and hospital between April 2014 to November 2015 after institutional ethical committee clearance. Read More

Appl Sci (Basel) 2019 Oct 16;9(20). Epub 2019 Oct 16.

Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA 02114, USA.

A critical element in understanding voice production mechanisms is the characterization of vocal fold collision, which is widely considered a primary etiological factor in the development of common phonotraumatic lesions such as nodules and polyps. This paper describes the development of a transoral, dual-sensor intraglottal/subglottal pressure probe for the simultaneous measurement of vocal fold collision and subglottal pressures during phonation using two miniature sensors positioned 7.6 mm apart at the distal end of a rigid cannula. Read More

Clin Otolaryngol 2019 11 11;44(6):975-982. Epub 2019 Sep 11.

Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Objective: Increasing evidence supports that auditory feedback of one's own voice closely relates to real-time adjustments of vocal control. Previous studies highlighted that the low-frequency modulations of below 3 Hz (LFM) embedded in vocal fundamental frequency (F0) showed a reflex-like response to altered auditory inputs. However, the auditory feedback control of different vocal disorders remains unclear. Read More

J Voice 2020 Nov 22;34(6):966.e1-966.e10. Epub 2019 Jul 22.

Department of Otolaryngology, University of Crete, Iraklion, Greece.

Background: Voice disorders influence the quality of people's life. When the type of disorder is determined then the clinicians are capable of finding their patients' needs and address their complaints concerning their vocal problems. One of the most used tools, for assessing the patients' quality of life (in accordance with their vocal status), is the Voice Handicap Index. Read More

Int J Pediatr Otorhinolaryngol 2019 Oct 4;125:147-152. Epub 2019 Jul 4.

Department of Audiology and Communication Disorders, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.

Objective: Despite the fact that vocal nodules are the most common cause of chronic dysphonia in children, uncertainty and lack of consensus complicates practically every diagnostic and management decision. Selecting an optimal staging system is fundamental to understanding a disease process, mandatory for uniform reporting, and crucial to predicting natural history and treatment outcomes. The ideal prognostic model for vocal nodules is under intense debate. Read More

Otolaryngol Clin North Am 2019 Aug 11;52(4):657-668. Epub 2019 May 11.

Pediatric Otolaryngology, Connecticut Children's Medical Center, 282 Washington, 2L, Hartford, CT 06106, USA; Department of Otolaryngology-Head and Neck Surgery, University of Connecticut Medical School, Farmington, CT, USA. Electronic address:

Dysphonia is common in pediatrics and affects individuals from infancy through their teenage years. Pediatric dysphonia has a variable impact on children, ranging from no impact to a severe social barrier. Although most etiologies are benign, potentially life-threatening causes must be ruled out by direct examination of the larynx. Read More