Journal of Voice最新文献

Objective: To explore different anesthesia techniques for medialization thyroplasty and determine how these anesthesia techniques may influence patient safety, patient experience, and surgical outcomes during medialization thyroplasty in adult patients.

Data sources: A comprehensive librarian-designed strategy was used to search EMBASE, MEDLINE, and Web of Science for English language studies from database inception to July 2023. The study was registered on Open Science Framework (10.17605/OSF.IO/R3BV2).

Review methods: Study selection was independently performed by two investigators for all English language studies of adult patients investigating anesthetic techniques for medialization thyroplasty with a minimum of five patients. Surgical outcomes (voice, perioperative complications, and swallowing), healthcare resource utilization metrics (operating time, length of stay), and patient-reported outcomes measures (PROMs) were analyzed. Study quality was assessed with the Oxford Levels of Evidence tool.

Results: From 354 articles, 28 studies were included. The most common anesthetic techniques were combined procedural sedation and local anesthesia (13/28 [46%]), local anesthesia alone (8/28 [29%]), and general anesthesia (GA) (7/28 [25%]). Six studies (21%) reported intraoperative complications (eg, desaturation), and eight (29%) studies reported postoperative complications (eg, airway obstruction). Voice outcomes were assessed in 14 (50%) studies. PROMs, including Voice Handicap Index (3/28 [11%]), were less commonly assessed. Intraoperative fiber-optic visualization was utilized in eight (29%) studies. Only one study assessed swallowing. Only two studies compared outcomes between anesthetic techniques. The median Oxford Level of Evidence was 4.

Conclusion: Medialization thyroplasty is performed under local anesthetic alone, with combined procedural sedation, and local anesthetic or with GA, with diverse approaches to airway management and minimal perioperative complications. Future research using standardized outcome measures is warranted due to the current paucity in the literature.

Objectives: This review aims to explore potential associations between immunological biomarkers and phonotraumatic vocal fold lesions.

Study design: Scoping review.

Methods: Ovid MEDLINE, CINAHL, PubMed, Proquest Theses and Dissertations, Scopus, and Web of Science were searched using the terms "vocal fold" and "inflammatory marker" initially, and later "development" and "phonotraumatic lesion." Papers were included for review if they were published in the last 20 years in English language, used human cell lines or biological samples, and outcomes were measured objectively using immunological biomarkers.

Results: In total, 4107 papers were identified for screening. The automation tools EndNote and Covidence removed 1257 duplicates. A further 2687 papers were excluded by reviewers at the title and abstract screening stage. The remaining 62 papers underwent full-text screening and 28 publications were ultimately included in the review.

Conclusions: Research concerning the possible association between immunological biomarkers and phonotraumatic lesions is still in its early stages, largely due to difficulty obtaining biological vocal fold samples in a safe and noninvasive manner, and challenges in identifying laboratory techniques that are sensitive enough to detect concentrations of biomarkers in small volumes of vocal fold samples. Signaling molecules are likely the most promising biomarkers to investigate the role of voice use patterns in the development of phonotraumatic lesions due to relatively rapid shifts in response to host conditions. Future research would benefit from control of potential systemic contributions to laryngeal manifestations of inflammation.

Objective: This study examines the demographic makeup of composers in Western classical art song anthologies and reference materials.

Design: Generalized (noncomposer or demographic-specific) musical anthologies (n = 379) and reference books (n = 29) were collected through commercial search engines, publisher websites, academic libraries, and private collections. Each composer's gender, race, sexuality, birth nationality, approximate musical period, and number of compositions were collated and categorized from each resource.

Methods: Definitions for demographic information were adapted from the United States Census Bureau and Human Rights Campaign to center the lens of a contemporary user's experience engaging with these texts. Basic statistics calculated using the composer's demographic information were multiplied by their total number of compositions to capture an aggregate understanding of what identities are likely to be encountered in such a resource.

Results: Data collection yielded 12,321 composers (unique n = 3971) and 56,847 songs with repetition. Generalized resources tend to contain the music of specific composer demographics. Included works were composed by primarily straight (n = 43,795, 77.0%), White (n = 55,661, 97.9%), or male (n = 53,864, 94.8%) composers. Z-test results showed significance when comparing musical resources with population estimates in all categories. Man, White, and Queer are significantly higher, while Woman, Black, Indigenous, People of Color (BIPOC), and Straight are lower in the aggregate data than in general population estimates. Man/White/Straight and Man/White/Queer are higher in the data, and all other groups are lower in the aggregate data than general population estimates.

Conclusions: The widespread use of art song resources representing a select portion of the available repertoire with unknown editorial impartiality could reinforce canonic ideology by limiting exposure to diverse repertoires. A "French Song" anthology is unlikely to have any women, BIPOC, or queer representation unless designed as a "Women in French Song," "BIPOC French Composers," or "Art Song by Queer French Composers" resource instead.

Purpose: Due to the elevated vocal risks of university professors and the possible relationship between auditory-motor integration and voice disorders, the current study was designed to explore the effects of altered auditory feedback via bone conduction on voice production measures in university professors.

Methods: A total of 43 hours of voice recordings across 32 university classes were collected from two vocally healthy college professors through voice dosimetry. During their classes, the professors experienced either the real-time altered auditory feedback or a condition without altered auditory feedback. The voice dosimetry recordings from all classes were processed to calculate the sound pressure level values, fundamental frequency values, and the time dose. The effects of the altered auditory feedback conditions on these voice acoustic parameters were analyzed and compared with the conditions without altered auditory feedback.

Results: The altered auditory feedback conditions resulted in significantly decreased sound pressure level values and time dose for both professors when comparing the altered auditory feedback conditions to the conditions without altered auditory feedback. The altered auditory feedback effects were larger for the male professor compared with the female professor. Additionally, the male professor demonstrated significantly decreased fundamental frequency values when comparing the altered auditory feedback conditions to the conditions without altered auditory feedback, while the female professor did not.

Conclusions: This study provides evidence that altered auditory feedback provided via bone conduction through an altered auditory feedback device resulted in statistically significant improvements in the voices of two college professors.

Objective: To evaluate whether Robotic or Laparoscopic Nissen Fundoplication (LNF) improves voice outcomes and symptoms in patients with Laryngopharyngeal Reflux (LPR) compared to patients who were candidates for surgery but elected to receive treatment with antireflux medical management alone.

Study design: Retrospective chart review.

Methods: A retrospective chart review was conducted of patients who visited the office of the senior author, received a diagnosis of LPR, and were candidates for LNF. Patients were categorized into two groups: those who received LNF surgery (Nissen-received, n = 50) and those who declined surgery (Nissen-declined, n = 54). Reflux Finding Scores (RFS) collected pre- and post-treatment were compared between groups. 24-hour pH-impedance results also were evaluated pre- and post-treatment.

Results: 24-hour pH-impedance testing from patients in the Nissen-received group showed a statistically significant decrease in six recording categories at the proximal sensor and five at the distal sensor, pre- to post-Nissen fundoplication. Proximal sensor categories included: (1) total reflux, (2) supine reflux, (3) acidic reflux, (4) weakly acidic reflux, (5) upright reflux, and (6) total postprandial reflux. Distal sensor categories included: (1) total reflux, (2) weakly acidic reflux, (3) supine reflux, (4) upright reflux, and (5) upright weakly acidic reflux. There were statistically significant differences in the changes from pre- to post-intervention when comparing between the Nissen-received and Nissen-declined groups at three proximal and three distal recordings. The proximal recording categories were (1) total reflux, (2) upright reflux, and (3) upright weakly acidic reflux, and the distal sensor categories were (1) upright reflux, (2) upright weakly acidic reflux, and (3) weakly acidic reflux. The Nissen-received group demonstrated statistically significant improvements in total RFS score, as well as the subcategory score of erythema, from pre- to post-Nissen fundoplication. There were statistically significant differences in the subcategory scores of erythema and diffuse laryngeal edema when comparing the changes from pre- to post-intervention between the Nissen-received and Nissen-declined groups.

Conclusion: LNF provides improved LPR control compared with treatment with antireflux medication alone.