Journal of Voice最新文献_第9页

Auditory-Motor Function Pre- and Post-Therapy in Hyperfunctional Voice Disorders: A Case Series 嗓音功能亢进症治疗前后的听觉运动功能：病例系列。

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/j.jvoice.2023.08.017

Defne Abur , Robert E. Hillman , Cara E. Stepp

Objective/Hypothesis

Behavioral voice therapy is the most common treatment for hyperfunctional voice disorders (HVDs) but has limited long-term effectiveness since the comprehensive mechanisms underlying HVDs remain unclear. Recent work has implicated disordered sensorimotor integration during speech in some speakers with HVDs and suggests that auditory processing is a key factor to consider in HVD assessment and therapy. The purpose of this case-series study was to assess whether current voice therapy approaches for HVDs resulted in improvements to auditory-motor function.

Study Design

Longitudinal (pre-post) study.

Method

Pre and postvoice therapy for HVDs, 11 speakers underwent an assessment of auditory-motor function via auditory discrimination of vocal pitch, responses to unanticipated auditory perturbations, and responses to predictable auditory perturbations of vocal pitch.

Results

At the post-therapy session, 10 out of 11 participants demonstrated voice therapy success (via self-reported voice problems and/or auditory-perceptual judgements of voice by a clinician) and eight of the 11 participants demonstrated improvements in at least one measure of auditory discrimination and/or auditory-motor control. Specifically, three speakers demonstrated improvements in auditory discrimination, five speakers demonstrated improved (within typical cutoffs) responses to predictable perturbations, and two speakers demonstrated improvements in both auditory discrimination and auditory-motor measures.

Conclusions

Together, these findings support that voice therapy in individuals with HVDs may impact auditory-motor control and highlight the potential benefit of systematically addressing auditory function in voice therapy and assessment for HVDs.

目标/假设：行为嗓音疗法是治疗功能亢进性嗓音障碍（HVDs）最常用的方法，但由于 HVDs 的综合机制尚不清楚，因此长期疗效有限。最近的研究表明，一些患有嗓音功能亢进症的说话者在说话过程中出现了感觉运动整合障碍，这也表明听觉处理是嗓音功能亢进症评估和治疗中需要考虑的一个关键因素。本病例系列研究旨在评估目前针对 HVDs 的嗓音治疗方法是否能改善听觉运动功能：研究设计：纵向（前后）研究：研究设计：纵向研究（前-后研究）。方法：在对 HVDs 进行嗓音治疗前和治疗后，对 11 名说话者进行听觉运动功能评估，评估方法包括对声调的听觉辨别、对意外听觉干扰的反应以及对声调的可预测听觉干扰的反应：在治疗后的疗程中，11 名参与者中有 10 人的嗓音治疗取得了成功（通过自我报告的嗓音问题和/或临床医生对嗓音的听觉感知判断），11 名参与者中有 8 人的听觉辨别和/或听觉运动控制能力至少有一项得到了改善。具体而言，3 名参与者的听觉辨别能力有所改善，5 名参与者对可预测干扰的反应有所改善（在典型临界值范围内），2 名参与者的听觉辨别能力和听觉运动控制能力均有所改善：总之，这些研究结果证明，对 HVDs 患者进行嗓音治疗可能会影响听觉运动控制，并强调了在嗓音治疗和 HVDs 评估过程中系统地解决听觉功能问题的潜在益处。

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引用次数: 0

Vocal Vibration Opening Onset Position Abnormality in Patients With Adductor Spasmodic Dystonia by Using High-Speed Endoscopy 应用高速内窥镜检查外收肌痉挛性肌张力障碍患者的嗓音振动开放起始位置异常。

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/j.jvoice.2023.08.015

Xinlin Xu , Eyad Saleh , Margaret Rose Lacke , Jack J. Jiang , Peiyun Zhuang

Objective

To analyze vocal fold vibration onset in patients with adductor laryngeal dystonia (ADLD) by analyzing vocal vibration opening onset position (VVOOP).

Study design

Case-control study

Setting

A voice center.

Methods

Eleven patients with ADLD diagnosed in our voice center were enrolled in the ADLD group. Eleven healthy subjects matched by exact age and gender to the ADLD patients were selected as the control group. All subjects underwent laryngeal high-speed video endoscopy. VVOOP and its change were assessed by two otolaryngologists. The multiline video kymography was used to analyze the open quotient (OQ) and standard deviation of OQ.

Results

VVOOP had more than one position in 54.6% (6/11) of the patients with ADLD, which was higher than the control group (P < 0.05). VVOOP appeared in the front of the vocal fold in 54.6% (6/11) of patients with ADLD and in the back of the vocal fold in 81.8% (9/11) of patients with ADLD. VVOOP can be abnormal in 90.9% (10/11) of patients with ADLD, and the rate of VVOOP abnormality was higher than that of the control group (P < 0.05). Of 11, 6 (54.6%) patients with ADLD had a variable VVOOP; the variability rate of VVOOP was higher than that in the control group (P < 0.05). OQ and OQ standard deviation in the ADLD group were significantly greater than in the control group (P < 0.05).

Conclusions

In patients with ADLD, vocal fold vibration was irregular, and VVOOP was abnormal and had a variable position and could reflect variability of the vocal vibration.

Level of evidence

Level 4.

目的：通过分析声带振动开放起始位置（VVOOP），分析喉收肌张力障碍（ADLD）患者的声带振动发作。研究设计：病例对照研究单位：语音中心。方法：11例在我们的语音中心诊断为ADLD的患者被纳入ADLD组。选择11名按确切年龄和性别与ADLD患者匹配的健康受试者作为对照组。所有受试者均接受了喉部高速视频内窥镜检查。两位耳鼻喉科医生对VVOOP及其变化进行了评估。结果：在54.6%（6/11）的ADLD患者中，VVOOP有一个以上位置，结论：ADLD患者声带振动不规则，VVOOP异常，位置可变，能反映声带振动的变异性。

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引用次数: 0

Diagnostic Value of Pepsin Measurements in Dysphonia Attributed to Laryngopharyngeal Reflux Disease 胃蛋白酶测定对咽喉反流性疾病所致发音障碍的诊断价值

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/j.jvoice.2023.07.020

Jerome R. Lechien , Abdul-Latif Hamdan

Objective

To investigate the diagnostic value of pepsin test in detecting laryngopharyngeal reflux (LPR) in patients with suspected LPR-induced dysphonia.

Methods

Dysphonic and non-dysphonic patients with LPR at the 24-hour hypopharyngeal-esophageal impedance-pH monitoring (HEMII-pH) were recruited from January 2019 to November 2022. Patients collected saliva/sputum samples to measure pepsin concentrations. Symptoms and findings were studied through reflux symptom score (RSS) and reflux sign assessment (RSA). Voice quality was assessed with maximum phonation time, GRBAS, voice handicap index (VHI), and acoustic parameters at baseline and 3-month post-treatment. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of pepsin tests for dysphonia-related to LPR were calculated at ≥16 ng/mL cutoff. The relationship between HEMII-pH, clinical features, voice quality outcomes, and pepsin measurement was investigated.

Results

Sixty-seven patients with LPR at the HEMII-pH completed the evaluations accounting for 30 patients consulting for dysphonia. Dysphonic patients reported higher RSS than non-dysphonic patients. RSS, RSA, laryngeal findings, VHI, and grade of dysphonia significantly improved from baseline to 3-month posttreatment. Pepsin test detected LPR in 73% of dysphonic cases. The pepsin test was 73.3 sensitive and 18.9 specific when considering the highest pepsin level of morning, postlunch, and postdinner sputum collections. Sensitivity, specificity, PPV, and NPV varied regarding the time of sputum collections. There was a strong significant association between the concentration of the morning pepsin test and the severity of laryngeal RSA score (P = 0.018). The morning pepsin saliva test concentration was predictive of the 3-month otolaryngological RSS (P = 0.014).

Conclusion

Pepsin test is a sensitive but poorly specific diagnostic approach for patients with dysphonia attributed to LPR. Multiple pepsin measurements may increase the sensitivity and predictive value of pepsin test. Future large-cohort studies are needed to investigate the accuracy of pepsin test in this population.

目的探讨胃蛋白酶试验对疑似咽喉炎返流（LPR）患者的诊断价值。方法于2019年1月至2022年11月招募24小时下咽-食管阻抗- ph监测（HEMII-pH）的LPR患者和非发音障碍患者。患者采集唾液/痰液样本测定胃蛋白酶浓度。通过反流症状评分（RSS）和反流体征评估（RSA）研究症状和结果。在基线和治疗后3个月，通过最大发声时间、GRBAS、语音障碍指数（VHI）和声学参数来评估语音质量。以≥16 ng/mL为临界值计算胃蛋白酶试验对LPR相关语音障碍的敏感性、特异性、阳性（PPV）和阴性（NPV）预测值。研究了HEMII-pH、临床特征、语音质量结果和胃蛋白酶测量之间的关系。结果67例LPR患者在HEMII-pH完成了评估，其中30例患者咨询了语音障碍。发音障碍患者报告的相对过饱和度高于非发音障碍患者。从治疗后3个月开始，RSS、RSA、喉部表现、VHI和发声障碍等级显著改善。胃蛋白酶试验在73%的发音障碍病例中检测到LPR。考虑到早晨、午餐后和晚餐后痰中胃蛋白酶的最高水平，胃蛋白酶试验的敏感性为73.3，特异性为18.9。敏感性、特异性、PPV和NPV随痰液收集时间的不同而变化。晨胃蛋白酶试验浓度与喉喉RSA评分严重程度有显著相关性（P = 0.018）。早晨胃蛋白酶唾液试验浓度可预测3个月耳鼻喉科RSS （P = 0.014）。结论胃蛋白酶试验对LPR性发声障碍诊断敏感，但特异性较差。多次测定胃蛋白酶可提高胃蛋白酶试验的敏感性和预测价值。需要进一步的大队列研究来调查胃蛋白酶检测在这一人群中的准确性。

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引用次数: 0

Correlation Between Laryngoscopic Appearance and Histopathology in Vocal Fold Cysts 声带囊肿喉镜表现与组织病理学的关系

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/j.jvoice.2023.08.007

Daniel A. Alfonso-Ying , Christine M. Clark , Theresa Scognamiglio , Hal Rives , Lucian Sulica

Objectives/Hypothesis

Cysts are benign vocal fold lesions typically divided into mucous retention or epidermoid subtypes. The conventional paradigm that the former are translucent and the latter opaque fails to encompass the heterogeneity of cyst appearance on laryngoscopy. This study aims to characterize the relationships between clinical cyst characteristics and histopathology.

Study Design

Retrospective cohort

Methods

Clinicodemographic data, videostroboscopy findings, and histopathology results were retrospectively reviewed for adults who underwent surgical excision of vocal fold cysts at our institution between 2006 and 2021.

Results

Diagnostic histopathologic material was available for 69 patients (age: 50.4 ± 15.1 years, 68.1% female). Clinically, most cysts were opaque (69.6%) and located at the vibratory margin (82.6%). 11.6% were infraglottic. Significant associations existed between cyst location and epithelial type, with infraglottic cysts and those at the superior surface more commonly exhibiting ductal (P = 0.003) and squamous (P = 0.002) epithelium, respectively. Cyst opacity did not correlate with histopathology (P = 0.415). Epidermoid cysts were more likely to exhibit clinical inflammation (P = 0.002).

Conclusions

• Vocal fold cyst location, but not clinical appearance, appears to correlate with histopathology.

• Clinical signs of inflammation are significantly more common with epidermoid cysts.

目的/假设囊肿是良性声带病变，通常分为粘液潴留和表皮样亚型。传统的模式认为前者是半透明的，后者是不透明的，不能包括喉镜下囊肿外观的异质性。本研究旨在探讨囊肿的临床特征与组织病理学之间的关系。研究设计回顾性队列研究方法回顾性分析2006年至2021年在我院接受声带囊肿手术切除的成人临床人口学资料、视频频闪检查结果和组织病理学结果。结果69例患者（年龄：50.4±15.1岁，女性68.1%）获得诊断性组织病理学资料。临床上，大多数囊肿不透明（69.6%），位于振动边缘（82.6%）。11.6%为声带不全。囊肿的位置和上皮类型之间存在显著的相关性，其中纤裂性囊肿和上表面的囊肿更常见的表现为导管上皮（P = 0.003）和鳞状上皮（P = 0.002）。囊肿混浊与组织病理学无相关性（P = 0.415）。表皮样囊肿更容易出现临床炎症（P = 0.002）。结论：声带囊肿的位置，而不是临床表现，似乎与组织病理学有关。•炎症的临床症状在表皮样囊肿中更为常见。

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引用次数: 0

Vocal Outcomes Following Laser-Assisted Sulcus Release for Superficial and Deep Vocal Fold Sulcus 激光辅助松解声带浅沟和深沟后的发声效果

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/j.jvoice.2023.07.021

Nupur Kapoor Nerurkar, Zainab Nagree

Background

The objective is to study vocal outcomes following laser-assisted sulcus release (LASR), having documented the length and depth of the sulcus intraoperatively. LASR performed for superficial and deep sulci were included.

Study Design

Retrospective, observational.

Methods

The preoperative and 3-month postoperative and post voice-therapy Voice Handicap Index 10 (VHI), Grade-Roughness-Breathiness-Asthenia-Strain of the voice (GRBAS), Maximum Phonation Time (MPT), Fundamental Frequency (FO), and stroboscopy findings were noted retrospectively from our voice clinic records of LASR patients. Intraoperative sulci length and depth details were noted from records. Patients with coexisting lesions, surgically tackled, were excluded.

Results

In a total of 14 patients, 21 superficial sulci and eight deep sulci were operated by LASR. The average preoperative VHI improved from 25.3 to 9.9, GRBAS from 10.6 to 3.5, and MPT from 7.6 to 12.3 seconds. The preoperative average FO was 235.9 Hz in 12 patients (no pick-up in two) with a postoperative 248.4 Hz. Using the Mann-Whitney U test, we found a statistically significant improvement in MPT, VHI, and GRBAS of the patients. There was no significant improvement in the FO of the patients. There was no postoperative voice deterioration in any patient. A preoperative phonatory gap was found in all patients, which postoperatively was absent in 10, markedly decreased in three, present in one with stroboscopy revealing an improvement in mucosal wave amplitude in 13 patients. In four patients with deep bilateral sulci where the LASR had been ligament deep, VHI improved from 26 to 13.3, GRBAS from 12 to 6.5, and MPT from 4.3 to 9.5 seconds. Using the Mann-Whitney U test, all three parameters were significantly improved.

Conclusion

A statistically significant vocal improvement in VHI, GRBAS, and MPT was observed at 3 months, in superficial and deep sulci, operated by LASR. LASR is a simple, quick, and easily replicable surgery. Larger multi-centric studies with long-term follow-up are recommended.

目的是研究激光辅助沟释放（LASR）后的声带结果，术中记录了沟的长度和深度。包括浅沟和深沟LASR。研究设计：回顾性、观察性。方法回顾性分析LASR患者术前、术后3个月及治疗后语音障碍指数（VHI）、语音分级-粗糙-呼吸-无力-紧张（GRBAS）、最大发声时间（MPT）、基频（FO）和频闪检查结果。术中记录沟的长度和深度细节。同时存在病变，手术治疗的患者排除在外。结果14例患者行LASR手术，其中浅沟21例，深沟8例。术前平均VHI从25.3秒提高到9.9秒，GRBAS从10.6秒提高到3.5秒，MPT从7.6秒提高到12.3秒。12例患者术前平均FO为235.9 Hz（2例无回升），术后平均FO为248.4 Hz。使用Mann-Whitney U检验，我们发现患者的MPT、VHI和GRBAS有统计学上显著的改善。患者的FO没有明显改善。术后无一例患者嗓音恶化。术前所有患者均发现发音间隙，术后10例无发音间隙，3例明显减少，1例频闪镜显示13例患者粘膜波幅改善。在4例双侧深沟LASR韧带深的患者中，VHI从26秒提高到13.3秒，GRBAS从12秒提高到6.5秒，MPT从4.3秒提高到9.5秒。采用Mann-Whitney U检验，三个参数均有显著改善。结论LASR术后3个月VHI、GRBAS、MPT均有显著改善。LASR是一种简单、快速、容易复制的手术。建议进行长期随访的大型多中心研究。

{"title":"Vocal Outcomes Following Laser-Assisted Sulcus Release for Superficial and Deep Vocal Fold Sulcus","authors":"Nupur Kapoor Nerurkar, Zainab Nagree","doi":"10.1016/j.jvoice.2023.07.021","DOIUrl":"10.1016/j.jvoice.2023.07.021","url":null,"abstract":"<div><h3>Background</h3><div>The objective is to study vocal outcomes following laser-assisted sulcus release (LASR), having documented the length and depth of the sulcus intraoperatively. LASR performed for superficial and deep sulci were included.</div></div><div><h3>Study Design</h3><div>Retrospective, observational.</div></div><div><h3>Methods</h3><div>The preoperative and 3-month postoperative and post voice-therapy Voice Handicap Index 10 (VHI), Grade-Roughness-Breathiness-Asthenia-Strain of the voice (GRBAS), Maximum Phonation Time (MPT), Fundamental Frequency (FO), and stroboscopy findings were noted retrospectively from our voice clinic records of LASR patients. Intraoperative sulci length and depth details were noted from records. Patients with coexisting lesions, surgically tackled, were excluded.</div></div><div><h3>Results</h3><div>In a total of 14 patients, 21 superficial sulci and eight deep sulci were operated by LASR. The average preoperative VHI improved from 25.3 to 9.9, GRBAS from 10.6 to 3.5, and MPT from 7.6 to 12.3 seconds. The preoperative average FO was 235.9 Hz in 12 patients (no pick-up in two) with a postoperative 248.4 Hz. Using the Mann-Whitney <em>U</em> test, we found a statistically significant improvement in MPT, VHI, and GRBAS of the patients. There was no significant improvement in the FO of the patients. There was no postoperative voice deterioration in any patient. A preoperative phonatory gap was found in all patients, which postoperatively was absent in 10, markedly decreased in three, present in one with stroboscopy revealing an improvement in mucosal wave amplitude in 13 patients. In four patients with deep bilateral sulci where the LASR had been ligament deep, VHI improved from 26 to 13.3, GRBAS from 12 to 6.5, and MPT from 4.3 to 9.5 seconds. Using the Mann-Whitney <em>U</em> test, all three parameters were significantly improved.</div></div><div><h3>Conclusion</h3><div>A statistically significant vocal improvement in VHI, GRBAS, and MPT was observed at 3 months, in superficial and deep sulci, operated by LASR. LASR is a simple, quick, and easily replicable surgery. Larger multi-centric studies with long-term follow-up are recommended.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"40 1","pages":"Pages 52-59"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10430651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

University Professors’ Communicative Competence and Its Relationship With Interpersonal Communication and Voice Symptoms 大学教授的交际能力及其与人际交往和声音症状的关系。

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/j.jvoice.2023.08.025

Caroline Azevedo Maciel , Adriane Mesquita de Medeiros , Letícia Caldas Teixeira

Objective

To analyze the association between communicative competence self-assessment and interpersonal communication self-perception and voice symptoms in university professors.

Method

Cross-sectional, analytical, observational study in 322 professors, who answered sociodemographic and occupational questions and three self-perception protocols: Self-Assessment of Communication Competence (SACCom), Interpersonal Communication Competence Scale (ICCS), and Voice Symptom Scale (VoiSS). The dependent variable was SACCom’s yes/no answers. Univariate and multivariate descriptive and inferential data analyses were performed through logistic regression.

Results

Most professors were females (55.3%), worked 40 hours (96.6%), and self-reported voice symptoms (72.7%). The largest portion had been in the career for 11–22 years (38.2%). The final multivariate model demonstrated that better self-assessed communicative competence among professors (SACCom) is related to an absence of voice complaints (odds ratio (OR) = 2.17; 95% confidence interval (CI) 1.29–3.65) and better self-perceived interpersonal communication (ICCS) (OR = 1.05; 95% CI 1.02–1.08). The older the professor (OR = 1.03; 95% CI 1.01–1.06), the better their communicative competence (SACCom).

Conclusions

Study professors’ self-assessed communicative competence is predominantly high. Those with a better communicative competence self-assessment are older and vocally healthy and self-perceive greater interpersonal communication skills.

目的：分析大学教授的交际能力自我评估与人际交往自我感知和语音症状之间的关系。方法：对322名教授进行横断面、分析性、观察性研究，他们回答了社会人口学和职业问题以及三种自我感知协议：沟通能力自我评估（SACCom）、人际沟通能力量表（ICCS）和声音症状量表（VoiSS）。因变量是SACCom的是/否答案。通过逻辑回归进行单变量和多变量描述性和推断性数据分析。结果：大多数教授是女性（55.3%），工作40小时（96.6%），自我报告有语音症状（72.7%）。大部分教授在职业生涯中工作了11-22年（38.2%）。最终的多变量模型表明，教授自我评估的沟通能力（SACCom）更好与没有语音抱怨有关（优势比（OR）=2.17；95%置信区间（CI）1.29-3.65）和更好的自我感知人际沟通（ICCS）（OR=1.05；95%CI 1.02-1.08）。教授年龄越大（OR=1.03；95%CI 1.01-1.06），他们的沟通能力越好（SACCom）。那些具有更好的沟通能力自我评估的人年龄更大，嗓音健康，自我感知能力更强。

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引用次数: 0

Cryptococcal Laryngitis: Three Cases Managed With Potassium-Titanyl-Phosphate Laser and Literature Review 隐球菌性喉炎：磷酸钛钾激光治疗三例并文献复习。

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/j.jvoice.2023.08.020

Laura Lamprell, Matthew Broadhurst

Objectives

To present three case reports of cryptococcal laryngitis managed with potassium-titanyl-phosphate (KTP) laser, where only one case managed with KTP laser has previously been published to date to our knowledge. Further, to systematically review the medical literature and describe the epidemiology, clinical assessment, treatment, and prognosis of laryngeal cryptococcosis.

Methods

The PubMed, Embase, and OVID MEDLINE databases were searched using the terms “cryptococcal laryngitis” or “cryptococcus” and “larynx or laryngeal.”

Results

Thirty-eight cases were identified. The median age was 65 years with a 1 male:1.2 female ratio. Thirty-six cases (95%) presented with hoarseness. Twenty-one cases (55%) were systemically immunosuppressed and 19 (50%) were taking an inhaled corticosteroid. This paper lists the five clinical features (i. white exudate or lesion; ii. exophytic, verrucous or tumor-like mass; iii. diffuse erythema; iv. mucosal irregularity; v. thickened vocal fold) and four pathologic features or tests (i. Grocott Gomori Methenamine stain; ii. Mucicarmine stain; iii. fungal or yeast organisms; iv. fungal culture) that encompass 97% of cases of cryptococcal laryngitis reported in the medical literature. In 34 cases (89%), antifungal therapy was given. Four cases (11%) had excisional biopsy and 11 (29%) received combined surgery and medical therapy. There was uncomplicated resolution in 24 cases (63%).

Conclusion

Cryptococcal laryngitis is a rare cause of hoarseness that may be mistaken for malignancy or may be a manifestation of disseminated cryptococcal infection or underlying immunosuppression. Clinicians should be aware of the diagnostic features of cryptococcal laryngitis to facilitate diagnosis and treatment to prevent complicated disease and overly aggressive treatment.

目的：介绍三例用磷酸钛钾（KTP）激光治疗隐球菌性喉炎的病例报告，据我们所知，其中只有一例用KTP激光治疗。此外，系统地回顾医学文献，描述喉隐球菌病的流行病学、临床评估、治疗和预后。方法：检索PubMed、Embase和OVID MEDLINE数据库，使用术语“隐球菌性喉炎”或“隐球菌”和“喉或喉”。结果：确定了38例病例。中位年龄为65岁，男女比例为1∶1.2。声音嘶哑36例（95%）。21例（55%）全身免疫抑制，19例（50%）吸入皮质类固醇。本文列出了五种临床特征（i.白色渗出物或病变；ii.外生、疣状或肿瘤样肿块；iii.弥漫性红斑；iv.粘膜不规则；v.声带增厚）和四种病理特征或测试（i.Grocott-Gomori-Methenamine染色；ii.粘液敏染色；iii.真菌或酵母；iv.真菌培养），这些特征或测试涵盖了97%的隐球菌性喉炎病例医学文献中有报道。34例（89%）接受了抗真菌治疗。4例（11%）接受了切除活检，11例（29%）接受了手术和药物治疗。24例（63%）患者无并发症缓解。结论：隐球菌性喉炎是一种罕见的声音嘶哑原因，可能被误认为是恶性肿瘤，也可能是播散性隐球菌感染或潜在免疫抑制的表现。临床医生应了解隐球菌性喉炎的诊断特点，以便于诊断和治疗，防止复杂的疾病和过度积极的治疗。

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引用次数: 0

Evaluation and Management of Inflammatory Reactions to Vocal Fold Injection Laryngoplasty with Hyaluronic Acid 透明质酸声带注射喉成形术炎症反应的评价与处理

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/j.jvoice.2023.07.031

Dylan J. Cooper, Seth E. Kaplan

Objectives

Inflammatory reaction to vocal fold injection laryngoplasty with hyaluronic acid (HA) is a rare condition whose optimal management is not established. In this study, we aim to review the presentation of these reactions and outline an approach for evaluation and management.

Methods

We performed a retrospective review of all patients at our institution who underwent vocal fold injection augmentation with HA during the period extending from August 2018 until October 2022. We then identified patients with postinjection inflammatory reaction and reviewed demographic data, indication for injection, amount of HA injected, setting of procedure, and symptoms. The types of complication, management plan, onset, and time to complete resolution were also recorded. A comprehensive literature search for similar complications was conducted for comparative analysis. Once the available data were aggregated with our institutional experience, we developed an algorithmic approach to manage this condition.

Results

We identified 83 patients (124 vocal folds) who underwent vocal fold injection laryngoplasty with HA over a 4-year period. Four patients (4.8%) had a postprocedure inflammatory reaction (5.6% of all vocal folds). Of the four patients, three presented with dyspnea and stridor, while one presented with dysphonia, with onset of symptoms ranging from 24 to 48 hour postinjection. All patients were treated with corticosteroids. For comparative analysis, we identified 24 patients from the literature with reported inflammatory reactions to HA.

Conclusion

We suggest an algorithmic approach to managing laryngeal inflammation following HA injection. Familiarity with treatment for this rare complication is essential to avoid significant morbidity and achieve optimal outcomes.

Level of Evidence

4

目的透明质酸声带注射喉成形术后的炎症反应是一种罕见的疾病，其最佳治疗方法尚未确定。在本研究中，我们旨在回顾这些反应的表现，并概述评估和管理的方法。方法：我们对我院2018年8月至2022年10月期间接受HA声带注射增强术的所有患者进行回顾性分析。然后，我们确定了有注射后炎症反应的患者，并回顾了人口统计学数据、注射指征、注射HA量、手术设置和症状。同时记录并发症类型、治疗方案、发病情况和完全解决时间。对类似并发症进行全面的文献检索，进行比较分析。一旦现有数据与我们的机构经验相结合，我们就开发了一种算法方法来管理这种情况。结果我们确定了83例（124个声带）在4年期间接受了HA声带注射喉成形术。4例（4.8%）患者术后出现炎症反应（占所有声带的5.6%）。4例患者中，3例出现呼吸困难和喘鸣，1例出现发音困难，症状发作时间为注射后24 - 48小时。所有患者均接受皮质类固醇治疗。为了进行比较分析，我们从文献中确定了24例报告对HA有炎症反应的患者。结论：我们提出了一种治疗HA注射后喉部炎症的算法方法。熟悉这种罕见并发症的治疗方法对于避免严重的发病率和达到最佳结果至关重要。证据水平

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引用次数: 0

TOC TOC

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 DOI: 10.1016/S0892-1997(25)00554-5

引用次数: 0

Harvey M. Tucker, November 27, 1938-August 17, 2025. 哈维·塔克，1938年11月27日- 2025年8月17日。

IF 2.4 4区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Voice

Pub Date : 2026-01-01 Epub Date: 2025-12-08 DOI: 10.1016/j.jvoice.2025.11.006

Michael S Benninger

引用次数: 0