OBJECTIVE

To determine the association between e-cigarette vaping, voice quality and vocal cord integrity among patients aged 19 years old and above at the Quezon City General Hospital based on the Filipino Voice Handicap Index (VHI), laryngoscopy, and GRBAS scale.

Design: Cross-Sectional Study

Setting: Tertiary Government Training Hospital

Participants: Ninety-eight (98) participants aged 19 years old and above with no previously known laryngeal illness who use e-cigarettes, completed the Filipino VHI, laryngoscopic evaluation, and GRBAS evaluation were recruited in the study.

Out of 98 participants, 65.3% (64/98) and 34.7% (34/98) were current and past e-cigarette users, respectively, of which 30% (29/98) had abnormal laryngeal findings. Abnormal laryngeal findings were observed in 34.4% (22/64) and 20.6% (7/34) of current and past e-cigarette users, respectively, (p=.172) which include erythema, edema or swelling, vascularity, and mucus in the vocal folds. Asthma (OR=145.1, 95%CI=2.6-79.2, p=.015) and current smoking (OR=13.9, 95%CI=1.6-17.1, p=.016) were significantly associated with abnormal laryngeal findings, while current smoking was significantly associated with higher GRBAS scores (β=0.5, 95%CI=0.06-1.0, p=.025). Years vaping, pods and drops used, and nicotine content level were not significantly associated with abnormal laryngeal findings, GRBAS scores and VHI scores (p > .05).

In this study, the prevalence of abnormal laryngeal findings was 30% among e-cigarette users which was higher among current e-cigarette users than past users. Concurrent cigarette smoking was a significant predictor of abnormal endoscopic findings and voice quality. Further research is recommended to substantiate the association of e-cigarette vaping with voice quality and laryngeal integrity.

Objective:To explore the impacts of acupuncture and moxibustion combined with ABCLOVE voice training on voice function and the levels of inflammatory factors in patients who were diagnosed with vocal cord polyp and received operation. Methods:A total of 96 cases who received operation on vocal cord polyp were randomly assigned into two groups. The control group was given ABCLOVE voice training for rehabilitation after the operation. The study group was given acupuncture and moxibustion combined with ABCLOVE voice training. The voice function and the levels of inflammatory factors of the two groups were compared. Results:The effective rate of the study group was higher than that of the control group（P<0.05）. The scores of main symptoms such as hoarseness, dry mouth, and thirst in the study group were lower than those in the control group（P<0.05）. After 4 weeks of treatment, the voice fundamental frequency（F0） of the study group was higher than that of the control group（P<0.05）, the maximum phonation time（MPT） was longer than that of the control group（P<0.05）, and the voice fundamental frequency perturbation value（Jitter） and voice amplitude perturbation value（Shimmer） were lower than those of the control group（P<0.05）. The levels of serum interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） were lower than those of the control group（P<0.05）. Conclusion:Acupuncture and moxibustion combined with ABCLOVE voice training can obviously alleviate hoarseness and other symptoms, improve voice function and reduce the level of inflammatory factors, thus is an effective treatment for patients who received operation on vocal cord polyp.
Humans ; Moxibustion ; Polyps/therapy* ; Vocal Cords ; Acupuncture Therapy ; Voice Training ; Female ; Male ; Adult ; Middle Aged ; Interleukin-6/blood* ; Tumor Necrosis Factor-alpha/blood* ; Young Adult ; Laryngeal Diseases/therapy*

Pitch abnormalities are a common manifestation of various voice disorders, with complex pathophysiological mechanisms involving changes in vocal fold tension, mass, and neuromuscular dysfunction of the larynx. This study aims to investigate the underlying physiological mechanisms of pitch-related disorders and explore diagnostic and therapeutic approaches, providing insights for clinical management.
Humans ; Voice Disorders/therapy* ; Vocal Cords/physiopathology*

Objective:To explore the influence of voice training combined with active breathing and circulation techniques on voice recovery following vocal cord polyp surgery. Methods:A total of 110 patients who underwent vocal cord polyp surgery at our hospital from May 2022 to November 2023 were selected and randomly divided into a control group （n=55） and a combination group （n=55） using a random number table method. During the recovery period, both groups received dietary control and aerosol treatment. The control group participated in voice training, while the combination group received active breathing and circulation techniques in addition to voice training for 2 months. Morphological changes, voice acoustic indicators （Shimmer, Jitter, Maximum Phonation Time[MPT]）, and the Voice Handicap Index （VHI） were compared between the two groups, and clinical efficacy was evaluated. Results:The combination group demonstrated higher clinical efficacy after training compared to the control group, with a statistically significant difference （P<0.05）. The proportion of incomplete closure, abnormal mucosal wave, and supraglottic compensation decreased in both groups after training （P<0.05）. However, there was no significant difference in the proportions of incomplete closure and abnormal mucosal wave between the two groups （P>0.05）. Notably, the proportion of patients with supraglottic compensation in the combination group was lower than in the control group （P<0.05）. After training, the Shimmer and Jitter values decreased in both groups, with the combination group exhibiting lower values （P<0.05）. Conversely, the MPT values increased in both groups, again with higher values in the combination group （P<0.05）. Additionally, after training, the functional, physiological, and emotional scores of the VHI decreased in both groups, with the scores in the combination group lower than those in the control group, demonstrating statistical significance （P<0.05）. Conclusion:Voice training combined with active breathing and circulation techniques has a beneficial effect on recovery following vocal cord polyp surgery. This combined approach significantly improves vocal cord morphology and acoustic indices, alleviates voice disorders, and enhances overall voice recovery.
Humans ; Vocal Cords/surgery* ; Polyps/surgery* ; Voice Training ; Male ; Female ; Voice Quality ; Laryngeal Diseases/surgery* ; Voice ; Middle Aged ; Adult ; Respiration

As narrow band imaging（NBI） technology and research for vocal fold leukoplakia have advanced, the diagnostic and therapeutic paradigms for this condition have evolved significantly. This paper provides insight into the challenges of clinical management of vocal fold leukoplakia, drawing on our empirical findings to clarify the etiology, differential diagnosis, pathological grading, morphological characteristics, and recent therapeutic developments of this condition.
Humans ; Vocal Cords/pathology* ; Leukoplakia/therapy*

Over the past decade, the assessment and management of voice disorders have witnessed remarkable progress. The assessment framework encompasses a multidimensional system that includes subjective audio-perceptual assessment, objective acoustic analysis, voice-related quality of life assessment, laryngoscopy and vocal fold vibration evaluation, aerodynamic analysis and laryngeal electromyography. In China, the Expert Consensus for Assessment of Vocal Function was published in 2024. Therapeutically, continuous refinement of phonomicrosurgical techniques, injection laryngoplasty, laryngeal framework surgery, and laryngeal reinnervation procedures has yielded favorable functional outcomes in phonation and swallowing. Voice therapy delivered either as an adjunct to surgery or as a standalone intervention-now plays an indispensable role in comprehensive voice care. In the future, voice disorders will be assessed more precisely, treated more effectively, and supported by more comprehensive rehabilitation.
Humans ; Voice Disorders/diagnosis* ; Quality of Life ; Laryngoscopy ; Voice Training ; Voice Quality ; Vocal Cords ; Electromyography ; Laryngoplasty

Objective:To explore the clinical, imaging, and pathological features of glottic squamous cell carcinoma of the larynx and their relationship with prognosis. Methods:A retrospective analysis was conducted on the clinical, imaging, and pathological data of 130 patients with glottic squamous cell carcinoma of the larynx who were treated at the First People's Hospital of Yinchuan and the General Hospital of Ningxia Medical University from January 2018 to March 2023. Imaging examinations （CT and MRI） were used to evaluate the lesion boundary clarity, density, enhancement nature, and enhancement degree. Postoperative pathological examination was used to determine the pathological nature, immunohistochemistry, etc. Statistical methods such as χ² test, Spearman correlation analysis, multivariate logistic regression analysis, and Kaplan-Meier method were used to analyze the data. Results:Among the 130 patients, 127 were male and 3 were female, with an average age of （61.92±9.595） years. There was a correlation between clinical, imaging, and pathological features. Multivariate analysis showed that heterogeneous MRI density （OR=12.414;P=0.019） and squamous cell carcinoma as a subtype were correlated. The initial symptom of non-hoarseness （HR=6.045;P=0.010） and unclear MRI boundary （HR=12.559; P=0.029） were independent risk factors for poor prognosis in patients with glottic squamous cell carcinoma of the larynx. Conclusion:There is a correlation between the clinical, imaging, and pathological features of patients with glottic squamous cell carcinoma of the larynx, and they can affect prognosis. The initial symptom of non-hoarseness and unclear MRI boundary of the tumor are independent risk factors for poor prognosis.
Humans ; Laryngeal Neoplasms/diagnosis* ; Prognosis ; Male ; Female ; Retrospective Studies ; Middle Aged ; Carcinoma, Squamous Cell/diagnosis* ; Magnetic Resonance Imaging ; Glottis/pathology* ; Tomography, X-Ray Computed ; Aged

Objective:To investigate the clinical value of electronic laryngoscope combined with narrow band imaging（NBI） endoscope and its classification in the diagnosis of vocal cord leukoplakia. Methods:A retrospective analysis was performed on 115 cases of patients treated in the Department of Otolaryngology, Head and Neck Surgery, Nanjing Drum Tower Hospital from September 2020 to November 2022. All 115 cases were diagnosed with vocal cord leukogramma using the electronic laryngoscopy and narrow band imaging endoscopy, followed by pathological examination in the outpatient tissue biopsy. The morphological characteristics of vocal cord leukoplakia and the correlation between narrow band imaging classification and pathological results were investigated. Results:Among 115 cases of vocal cord leukoplakia, 46 cases（40.00%） were diagnosed as benign lesions. Low grade intraepithelial neoplasia occurred in 29 cases（25.22%）. High-grade intraepithelial neoplasia（including carcinoma in situ） occurred in 22 cases（19.13%）. Invasive carcinoma（including suspected invasive carcinoma） was found in 18 cases（15.65%）. There were no statistical differences in the unilateral and bilateral distribution of vocal cord leukoplakia and pathological results（P>0.05）, but there were statistical differences in the size, thickness, lesion uniformity, clear boundary, pre-invasion commissure, symmetry,age over 55 years old, morphological classification, NBI classification and pathological results distribution（P<0.05）. The two-by-two comparison among the three groups of morphological classification（flat type, raised type, rough type） showed that P<0.017 was only compared between flat type and rough type, and P>0.017 was compared between the other two groups. The pairwise comparison among the three groups of NBI classification（Ⅲ, Ⅳ, Ⅴ） was statistically significant（P<0.017）. There was a high correlation between NBI classification and pathological diagnosis, and the correlation coefficient was 0.705（P<0.05）. The risk of high intraepithelial neoplasia and cancerization in type Ⅳ was 9.125 times higher than that in type Ⅲ, and the risk of high intraepithelial neoplasia and cancerization in type Ⅴ was 271.078 times higher than that in type Ⅲ. The area under the curve of morphological classification and NBI classification were 0.672 and 0.896, respectively. Conclusion:There is a high match and correlation between NBI classification and pathological diagnosis. Electronic laryngoscope combined with narrow band imaging endoscope has a high diagnostic value for vocal cord leukoplakia, and a strong predictive ability for malignant leukoplakia.
Humans ; Vocal Cords/pathology* ; Male ; Female ; Leukoplakia/diagnosis* ; Narrow Band Imaging/methods* ; Retrospective Studies ; Laryngoscopy/methods* ; Middle Aged ; Laryngeal Neoplasms/diagnosis* ; Aged ; Laryngoscopes ; Adult

Objective:Patients with Laryngopharyngeal Reflux（LPR） have chronic inflammation of the laryngeal mucosa leading to a high response state in the larynx, which may make the vocal fold movement too fast. This paper discusses the characteristics of vocal fold movement and voice onset by analyzing laryngeal high-speed videoendoscopy in patients with LPR. Methods:Forty patients with LPR were enrolled as LPR group. The diagnostic criteria of LPR included positive reflux symptom index（RSI） and reflux syndrome score（RFS） to identify suspected LPR, objective oropharyngeal DX pH monitoring was carried out, and positive Ryan index indicated reflux. According to age and sex matching, 40 healthy volunteers were selected as the normal group. Laryngeal high-speed videoendoscopy, and the vocal fold motion and vibration parameters, including vocal fold adduction time, vocal fold abduction time, vocal fold vibration onset mode（vocal onset time and mode） and the opening quotient of vocal fold vibration cycle. Statistical analysis was performed using SPSS 25.0. Results:The time of vocal fold adduction in LPR group（mean 225.81ms） was less than that in normal group（mean 277.01 ms）, and the difference was statistically significant（P<0.05）. There was no significant difference in adduction time between LPR group and normal group（P>0.05）. The vocal onset time in LPR group was significantly longer than that in normal group（P<0.05）. High speed video endoscope showed that there were 17 patients with hard onset in LPR group and 8 patients with hard onset in normal group, the difference was statistically significant（P<0.05）. There was no significant difference in the open quotient of vocal fold vibration between LPR group and normal group（P>0.05）. The vocal fold abduction time in LPR group（mean 372.92 ms） was less than that in normal group（mean 426.98ms）, but the difference was not statistically significant（P>0.05）. The time difference of bilateral abduction of vocal fold in LPR group was significantly higher than that in normal group（P<0.05）. Conclusion:The larynx of LPR patients is in a high response state, the vocal fold moves faster, and it is more likely to have a hard vocal onset. These may result in voice dysfunction.
Humans ; Vocal Cords/physiopathology* ; Laryngopharyngeal Reflux/diagnosis* ; Laryngoscopy/methods* ; Male ; Video Recording ; Female ; Middle Aged ; Adult ; Voice/physiology* ; Case-Control Studies ; Vibration

Objective:To analyze the acoustic characteristics of patients with hypopharyngeal cancer accompanied by vocal cord dysfunction. Methods:A retrospective analysis was conducted on the data of patients with hypopharyngeal cancer who were initially treated at The Second Affiliated Hospital of Xi'an Jiaotong University from January 2018 to April 2024. Patients who had completed electronic laryngoscopy, stroboscopic laryngoscopy, and voice analysis were selected from the data. Among them, patients with hypopharyngeal cancer who had unilateral vocal cord activity disorders were selected as the experimental group, while patients with symmetrical bilateral vocal cord activity were assigned to the control group. Then the clinical characteristics, the vocal parameters, and the stroboscopic laryngoscopy results of patients with hypopharyngeal cancer in the experimental group and the control group were analyzed and compared. Results:Compared with that in the control group, the proportion of lesions located on the inner wall of the piriform fossa in the experimental group increased（83.3% vs 53.8%）, and the difference was statistically significant（P<0.05）. There was no significant difference in vocal parameters such as SPL, Jitter, Shimmer, MPT, DSI, F0, sound intensity, electroglottic value and VHI between the experimental group and the control group（P>0.05）. However, the values of F0, Jitter, Shimmer and VHI in the experimental group were higher than those in the control group. In addition, in terms of the results of stroboscopic laryngoscopy, the proportion of glottic insufficiency（42.9% vs 18.8%） and asymmetric arytenoid cartilage（64.3% vs 0） in the experimental group was significantly higher than that in the control group（P<0.05）. However, the mucosal waves of the vocal cords on the affected side did not weaken in patients in both the experimental group and the control group. In the experimental group of 18 patients with hypopharyngeal cancer who received induction chemotherapy（nituzumab+nedaplatin+5-fluorouracil）, 13 of them had improved vocal cord activity（improvement rate of 72.2%）. Conclusion:Hypopharyngeal cancer in the medial wall of the pyriform fossa is more prone to vocal cord dysfunction, but vocal cord dysfunction has little effect on the vocal parameters of patients with hypopharyngeal cancer.
Humans ; Hypopharyngeal Neoplasms ; Retrospective Studies ; Male ; Female ; Laryngoscopy ; Middle Aged ; Vocal Cord Dysfunction/etiology* ; Vocal Cords/physiopathology* ; Stroboscopy ; Voice Quality ; Aged