Creating an Undergraduate Research Program in Otolaryngology-Head and Neck Surgery (Oto-HNS) for Students Underrepresented in Medicine.

Objectives: To report implementation and outcomes associated with a novel paid Summer Undergraduate Research Education Program (SREP) over the first 2 years in an academic otolaryngology program recruiting students underrepresented in medicine (URiM).

Methods: A 10-week program including a research bootcamp, curriculum, mentoring, and clinical shadowing was created. Grant funding to provide salary and support for transportation, conference attendance, and graduate school preparation or applications was procured.

Vocal Effort and Acoustic Analysis of Gargle Phonation Versus Water Swallow in Patients With Muscle Tension Dysphonia: A Clinical Trial.

Purpose: To determine the effects of gargle phonation (GP) on self-perceived vocal improvement, vocal effort, acoustic parameters, and speech rate in patients with muscle tension dysphonia (MTD). We hypothesized that GP would improve voice, reduce phonatory effort, and alter acoustic and speech measures.

Study Design: Prospective randomized, single-blind cross-over clinical trial METHODS: Thirty-four participants (26 females, 8 males; average age 53 years) who were diagnosed with MTD completed the Voice Handicap Index-10 (VHI-10) and were assigned three study conditions: Baseline (B), GP, and Water Swallow (WS; sham), presented in one of two counterbalanced orders B-WS-GP (WS) or B-GP-WS (GP).

Guess What We Can Hear-Novel Voice Biomarkers for the Remote Detection of Disease.

The advancement of digital biomarkers and the provision of remote health care greatly progressed during the coronavirus disease 2019 global pandemic. Combining voice/speech data with artificial intelligence and machine-based learning offers a novel solution to the growing demand for telemedicine. Voice biomarkers, obtained from the extraction of characteristic acoustic and linguistic features, are associated with a variety of diseases and even coronavirus disease 2019.

Visual Gaze Patterns in the Analysis of Glottic Lesions: Does Experience Increase Diagnostic Accuracy?

Objectives: The purpose of this study was to evaluate visual gaze patterns and the ability to correctly identify cancer among participants of different experience levels when viewing benign and malignant vocal cord lesions.

Methods: Thirty-one participants were divided into groups based on level of experience. These included novice (medical students, PGY1-2 otolaryngology residents), intermediate (PGY3-5 otolaryngology residents, gastroenterology fellow), advanced practice providers (physician assistants, nurse practitioners, and speech language pathologists), and experts (board-certified otolaryngologists).

Landmark-based analysis of speech differentiates conversational from clear speech in speakers with muscle tension dysphonia.

This study evaluated the feasibility of differentiating conversational and clear speech produced by individuals with muscle tension dysphonia (MTD) using landmark-based analysis of speech (LMBAS). Thirty-four adult speakers with MTD recorded conversational and clear speech, with 27 of them able to produce clear speech. The recordings of these individuals were analyzed with the open-source LMBAS program, SpeechMark®, matlab Toolbox version 1.

Visual Interpretation of Vocal Fold Paralysis in Flexible Laryngoscopy Using Eye Tracking Technology.

Objectives: Interpretation of laryngoscopy is an important diagnostic skill in otolaryngology. There is, however, limited understanding of the specific visual strategies used while assessing flexible laryngoscopy video. Eye-tracking technology allows for objective study of eye movements during dynamic tasks.

Singing Voice Concern in Tertiary Laryngology Practice.

Objectives: To determine the prevalence and characteristics of patients who identify singing voice as a primary concern when presenting with general voice complaints to a voice clinic.

Methods: Data were collected from medical records on demographics, medical history, laryngoscopy exam, diagnosis, and subsequent treatments; and from self-report questionnaires including the Voice Handicap Index-10 (VHI-10) and clinical voice questionnaire.

Results: A total of 17% of patients presenting to a voice clinic with general voice problems who completed a VHI-10 identified singing voice as a primary concern.

Noninvasive Voice Biomarker Is Associated With Incident Coronary Artery Disease Events at Follow-up.

Objective: To evaluate the association between a preidentified voice biomarker and incident coronary artery disease (CAD) events.

Methods: Patients referred for clinically indicated coronary angiography underwent a total of three 30-second voice recordings using the Vocalis Health smartphone application between January 1, 2015, and February 28, 2017. A pre-established voice biomarker was derived from each individual recording, and the mean biomarker value was calculated for each patient.

Predicting Gag, Discomfort, and Laryngeal Visualization in Patients Undergoing Flexible Laryngoscopy with Stroboscopy.

Objective: To investigate potential associations between the Predictive Gagging Survey (PGS) with patient experience of gag and discomfort as well as provider perception of patient gag and level of laryngeal visualization during flexible laryngoscopy with stroboscopy (FL-S).

Methods: A total of 53 adult patients undergoing FL-S were recruited for this prospective non-controlled study. PGS was completed before FL-S.

Speech Pathology Utilization and Stroboscopy Before and After Adult Medialization Laryngoplasty.

Objectives: Evaluation of trends and utilization of speech-language-pathology (SLP) services, including stroboscopy, before and after medialization laryngoplasty (ML) over 11 years.

Methods: Retrospective national US database study conducted using OptumLabs Data Warehouse. Study cohort included patients (age ≥18 years) who underwent ML between January 2007 and December 2016.

Cardiothoracic Patients with Unilateral Vocal Fold Paralysis: Pneumonia Rates Following Injection Laryngoplasty.

Objective: Recurrent laryngeal nerve injury is a potential complication of cardiothoracic surgery and cause of unilateral vocal fold paralysis (UVFP). Injection laryngoplasty (IL) is an intervention offered to patients with UVFP to alleviate symptoms including dysphagia, dysphonia and weak cough. There is no definitive evidence that IL prevents pneumonia.

Non-invasive vocal biomarker is associated with pulmonary hypertension.

Emerging data suggest that noninvasive voice biomarker analysis is associated with coronary artery disease. We recently showed that a vocal biomarker was associated with hospitalization and heart failure in patients with heart failure. We evaluate the association between a vocal biomarker and invasively measured indices of pulmonary hypertension (PH).

Breathiness and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) in Patients Undergoing Medialization Laryngoplasty With or Without Arytenoid Adduction.

Objectives: We hypothesized that, in patients with unilateral vocal fold paralysis (UVFP), the auditory-perception of breathiness measured with Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) would be higher preoperatively in patients who undergo medialization laryngoplasty (ML) with arytenoid adduction (AA) compared to ML alone. We further hypothesized that increased breathiness would correlate with increased glottal area at maximum glottal closure.

Study Design: Retrospective chart review.

Voice outcomes following medialization laryngoplasty with and without arytenoid adduction.

Objective: Voice outcomes following medialization laryngoplasty (ML) for unilateral vocal fold paralysis (UVFP) were compared to those who underwent ML plus arytenoid adduction (AA) (ML+AA).

Methods: Single institution retrospective review of patients with UVFP undergoing ML and ML+AA (2009-2017). Demographic information and history of laryngeal procedures were collected.

Medialization laryngoplasty/arytenoid adduction: U.S. outcomes, discharge status, and utilization trends.

Objectives/hypothesis: To evaluate trends, outcomes, and healthcare utilization following medialization laryngoplasty (ML) with or without arytenoid adduction (AA) over 10 years.

Study Design: Retrospective observational study.

Methods: Using OptumLabs Data Warehouse, trends, outcomes, and healthcare utilization from 2006 to 2015 were examined with a focus on discharge type (same day or not).

Can Ultrasound Identify Paradoxical Vocal Fold Movement? A Pilot Study.

Objective: Vocal cord dysfunction (VCD) is characterized by paradoxical vocal fold movement (PVFM) during inspiration. The aim of this study was to determine whether ultrasound could accurately differentiate between normal and PVFM during respirations in a resting state.

Design: Prospective, single-subject design.

Voice Signal Characteristics Are Independently Associated With Coronary Artery Disease.

Objective: Voice signal analysis is an emerging noninvasive diagnostic tool. The current study tested the hypothesis that patient voice signal characteristics are associated with the presence of coronary artery disease (CAD).

Methods: The study population included 138 patients who were enrolled between January 1, 2015, and February 28, 2017: 37 control subjects and 101 subjects who underwent planned coronary angiogram.

Observational study of laryngoscopy plus flow-volume loops during exercise.

Laryngoscopy is the gold standard to diagnose exercise-induced laryngeal obstruction, though inspiratory flow-volume loop may provide a clue. We combined tidal flow-volume loop analysis laryngoscopy during exercise and found that cigar-shaped - flattened - inspiratory loops are associated with obstruction. Pursed-lip breathing slows inhalation thereby reducing vocal fold adduction.

Symptomatic unilateral vocal fold paralysis following cardiothoracic surgery.

Purpose: Unilateral vocal fold paralysis (UVFP) is a complication associated with cardiothoracic procedures that presents clinically as dysphonia and/or dysphagia with or without aspiration. The literature lacks both data on recovery of mobility and consensus on best management. Herein, our goals are to 1) Identify cardiothoracic procedures associated with symptomatic UVFP at our institution; 2) Review timing and nature of laryngology diagnosis and management; 3) Report spontaneous recovery rate of vocal fold mobility.

Bilateral Thyroarytenoid Botulinum Toxin Type A Injection for the Treatment of Refractory Chronic Cough.

Importance: Refractory chronic cough is a debilitating condition with limited therapeutic options. Laryngeal botulinum toxin type A (BtxA) has been anecdotally reported to benefit patients with chronic cough. We report on our experience with the use of BtxA for the treatment of patients with refractory chronic cough.

Thyroplasty in the previously irradiated neck: A case series and short-term outcomes.

Objectives/hypothesis: External beam radiation to the neck is widely considered a contraindication for thyroplasty due to concern for infection and implant extrusion. We present a case series of our experience regarding thyroplasty performed in a previously radiated field.

Study Design: Retrospective case study at a tertiary academic referral center.