Search Our Scientific Publications & Authors

Int J Med Sci 2022 1;19(5):813-820. Epub 2022 May 1.

Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.

Vocal fold nodules (VFNs) are the most frequent cause of hoarseness. The management comprised medical, surgical and physical therapy but the effectiveness is not always satisfactory. In this study, we try to figure out an alternative treatment from our clinical experience summary. Read More

Int J Pediatr Otorhinolaryngol 2022 Jun 26;157:111118. Epub 2022 Mar 26.

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA, USA.

Introduction: Down syndrome is the most common chromosomal abnormality and is associated with a higher incidence of congenital heart defects, which often require surgery within the first year of life. Previous studies have found that children with Down syndrome are at higher risk for subglottic stenosis, vocal fold paralysis, and laryngomalacia. The goal of this study is to review children with Down syndrome presenting with dysphonia and to characterize their laryngeal pathologies. Read More

J Voice 2022 Feb 6. Epub 2022 Feb 6.

Department of Surgery, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.

Objective: To examine the immediate impact of 30 minutes of targeted voice exercises on measures of vocal function and lesion characteristics in female speakers with phonotraumatic vocal fold lesions (PVFLs).

Study Design: Prospective cohort study.

Method: Twenty-nine (n = 29) female subjects with PVFLs completed a 30 minutes targeted voice exercise protocol and a multidimensional voice analysis was conducted immediately pre and post-exercise. Read More

Int J Comput Assist Radiol Surg 2022 Mar 13;17(3):497-505. Epub 2022 Jan 13.

Institute of Forming Technology & Equipment, Shanghai Jiao Tong University, Shanghai, 200030, China.

Purpose: Currently, self-retaining laryngoscopic surgery is not suitable for some patients, and there are dead zones relating to surgical field exposure and operation. The quality of the surgery can also be affected by the long periods of time required to complete it. Teleoperated continuum robots with flexible joints are expected to solve these issues. Read More

Laryngoscope 2022 Jan 13. Epub 2022 Jan 13.

Clinical Center for Voice Care, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.

Objectives: To discover patterns of phonotraumatic lesions in singers and investigate factors that differentiate those who underwent surgery from those who did not. We hypothesized that 1) lesion type distribution differs by age, sex, singer classification (professional/amateur), and history of formal voice training; 2) the likelihood of surgery is associated with singer classification and voice training.

Study Design: Retrospective. Read More

Acta Otolaryngol 2021 Nov 9;141(11):1005-1013. Epub 2021 Nov 9.

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

Background: Benign vocal fold lesions (BVFLs) can cause voice changes, including reduced loudness and pitch range. In recent times, with progression in endoscopic technology, office-based vocal fold steroid injection (VFSI) has been used as an alternative therapy for BVFLs.

Aims/objectives: In this study, we analyzed the efficacy and safety of VFSI to investigate the mechanism underlying its therapeutic effects and determine the conditions in which VFSI will be most effective. Read More

Int Arch Otorhinolaryngol 2021 Oct 30;25(4):e496-e503. Epub 2020 Nov 30.

Department of Surgical Clinics, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.

 The study of larynx lesions is of great importance. More than 50% of people with vocal complaints have benign vocal fold alterations and some require surgery.  To determine which factors are related to surgical recurrence of benign laryngeal lesions and to determine which videolaryngoscopic diagnoses are related to the risk or protection of surgical relapses over time. Read More

Cancers (Basel) 2021 Aug 26;13(17). Epub 2021 Aug 26.

Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria.

Background: The aim of this study was to (i) determine IMP3 protein expression in benign and malignant laryngeal lesions, (ii) compare its expression to Ki-67, p53, cyclin D1, and (iii) finally, to examine the prognostic power of IMP3 in squamous cell carcinomas of the larynx (LSSC).

Methods: IMP3 protein expression was evaluated in 145 patients, including 62 LSCC, 45 dysplasia (25 with low and 20 with high-grade dysplasia), and 38 benign lesions (vocal cord polyps and nodules).

Results: IMP3 was significantly higher expressed in LSCC compared to dysplasia and benign lesions ( < 0. Read More

J Voice 2021 Jul 17. Epub 2021 Jul 17.

Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Objectives: Local injection of glucocorticoids (GCs) into the vocal folds has been used for treating the vocal fold lesions. While the positive effects on vocal fold nodules, polyps, or scarring have been clinically reported, some concern remains around the potential adverse effects such as vocal fold atrophy, and the mechanisms remain unclear. The present study examined the histology and gene expression of locally injected GC into the vocal folds in rats. Read More

J Formos Med Assoc 2022 Jan 25;121(1 Pt 2):329-334. Epub 2021 May 25.

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 Aug 23;278(8):2937-2942. 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 11 9;131(11):2523-2529. 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

Am J Speech Lang Pathol 2021 03 22;30(2):772-788. Epub 2021 Mar 22.

Department of Communication Sciences & Disorders, University of Delaware, Newark.

Purpose This systematic review aims to identify, classify, and evaluate existing information regarding treatment for benign vocal fold lesions in children and to identify gaps and limitations that may limit effective pediatric voice treatment. Method A literature search was performed using electronic databases (PubMed and Google Scholar) as well as reference lists from previous reviews, studies, and books. Included in the present review are studies that described behavioral treatment for children with benign vocal fold lesions presumed to be phonotraumatic (vocal fold nodules and edema). Read More

Ann Otol Rhinol Laryngol 2021 Nov 18;130(11):1263-1267. Epub 2021 Mar 18.

Depatment of Otolaryngology, Antalya Training and Research Hospital, Antalya, Turkey.

Objectives: Vocal fold nodules (VFN) are a bilateral epithelial thickening of the membranous vocal folds. In this study, children with VFN and their mothers took part in voice therapy. We then compared acoustic analyzes and subjective evaluations to those in previous literature to determine whether voice therapy is more effective for children with VFN when their mothers also take part in therapy. 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 07 9;131(7):E2284-E2291. 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 2022 02 28;132 Suppl 4:S1-S8. 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 2021 Jul 24;35(4):665.e7-665.e12. Epub 2020 Mar 24.

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