UCSF Voice & Swallowing Center Presentations
2022 Combined Otolaryngology Spring Meetings
Title: Longitudinal Analysis of Swallowing Displacement Kinematics and Functional Swallowing Outcome Measures After Oropharyngeal Cancer Treatment
Authors: Joseph Kidane, Arushi Gulati, Grant E. Gochman, Jason W. Chan MD, William R. Ryan MD, Sarah Schneider CCC-SLP, Joey Laus CCC-SLP, Yue Ma MD
Meeting: American Broncho-Esophagological Association
Type of Presentation: Podium
Title: Assessment of Laryngopharyngeal Sensory Function Using Tactile Aesthesiometer in Healthy Adults
Authors: Yue Ma MD, Joseph Kidane, David J. Bracken MD, Grant E. Gochman, Clark A. Rosen MD, VyVy N. Young MD
Meeting: American Broncho-Esophagological Association
Type of Presentation: Podium
Title: Interventions and Outcomes in Posterior Glottic Versus Multi-level Airway Stenosis: A Multi-institutional Review
Authors: Grant E. Gochman, Shambavi Rao, Anastasiya Stasyuk, Kychelle L. Del Rosario, Daniel J. Cates MD, Lyndsay L. Madden DO, VyVy N. Young MD
Meeting: American Broncho-Esophagological Association
Type of Presentation: Podium
Title: Laser Safety Time Out: Quality Improvement at a Tertiary Care Center
Authors: Elizabeth A. Shuman MD, Madeleine P. Strohl MD, Clark A. Rosen MD
Meeting: American Broncho-Esophagological Association
Type of Presentation: Poster
Title: Increased Laryngopharyngeal Sensation in Adductor Spasmodic Dysphonia Compared to Healthy Controls
Authors: VyVy N. Young MD, Joseph Kidane, David J. Bracken MD, Grant E. Gochman, Yue Ma MD, Clark A. Rosen MD
Meeting: American Laryngological Association
Type of Presentation: Podium
Title: Quality of Life Instruments Use in Laryngeal Movement Disorders-Exploring the Patient’s Preference
Authors: Grant E. Gochman, Christopher D. Dwyer MD, VyVy N. Young MD, Clark A. Rosen MD
Meeting: American Laryngological Association
Type of Presentation: Poster
Title: Influence of Angle, Moisture, and Compressions on Tactile Aesthesiometer Force in Laryngopharyngeal Sensory Testing
Authors: Joseph Kidane, Grant E. Gochman, John Boscardin, VyVy N. Young MD, Clark A. Rosen MD, Yue Ma MD
Meeting: The Triological Society
Type of Presentation: Poster
Title: Using Item-Response Theory to Improve Interpretation of the Trans Woman Voice Questionnaire (TWVQ)
Authors: Nina W. Zhao, MD, MAEd; James M. Mason, MEd; Alexander M. Blum, PhD; Eric K. Kim, BA; VyVy N. Young, MD; Clark A. Rosen, MD; Sarah L. Schneider, CCC-SLP
Type of Presentation: Poster
2020 Virtual Fall Voice Conference
Laryngeal Electromyography Abnormal Findings In Asymptomatic Adults Across The Age SP
Remote Voice Testing Fall Voice 2020 Final
- Creation and Implementation of the UCSF Laryngeal Symptom Diary (PDF)
- Novel Application of Quantitative Electromyography to Guide Botulinum Toxin Injection for Spasmodic Dysphonia (PDF)
- Cultural Adaptation and Validation of Speech Handicap Index (SHI): A Scoping Review (PDF)
- Association Between Quality of Life Questionnaires: Towards Laryngology PROM Reduction (PDF)
- Voice and Stroboscopic Characteristics in Transgender Patients Seeking Gender-Affirming Voice Care (PDF)
Ongoing Research
Assessment of Laryngopharyngeal Sensation in Patients with Laryngopharyngeal Disorders
Disorders: Normal subjects, Dysphagia, Spasmodic Dysphonia, Vocal Fold Paralysis
Eligible Subjects: English-speaking persons aged 18 years and older
Information: Altered sensation of the throat and voice box (increased or decreased) is thought to be an important factor in many different voice and swallowing disorders. Currently, testing of sensation in these areas has been difficult and non-standardized. Our group has developed and validated a novel tool to test sensation of the throat and voice box. We will be recruiting patients with various voice and swallowing disorders to investigate and assess for the potential role of abnormal sensation.
Correlation between Montreal Cognitive Assessment (MoCA) and Voice, Swallowing and Upper Airway Therapy Outcomes in the Aging Treatment-Seeking Population
Disorders: aging voice and/or swallowing, cough, paradoxical vocal fold motion/vocal cord dysfunction
Eligible Subjects: English-speaking patients aged 60 years old and older who are seeking care for a laryngological disorder and are candidates for voice, swallowing or upper airway therapy
Information: We are investigating if the performance on the Montreal Cognitive Assessment (MoCA) is associated or predictive of the outcomes in voice, swallowing or upper airway therapy in the older laryngology treatment seeking patients. The relationship between the scores of MoCA and parameters in therapy will be analyzed. The outcomes of this study could potentially impact how we determine candidacy for therapy and develop patient treatment plans to meet their needs. This is a collaborative study with Emory Voice Center and the NYU Voice Center.
Multi-institutional Airway Stenosis Study
Disorders: subglottic stenosis, tracheal stenosis, posterior glottic stenosis
Eligible Subjects: any patients with any degree or location of stenosis (narrowing) of the airway
Information: Stenosis (narrowing) of the breathing passageway can occur because of prolonged intubation, trauma, autoimmune disease, or idiopathic (unknown) cause. Some patients even require a tracheostomy tube (breathing tube in the neck) to help them breathe because of the stenosis. Treatment to improve breathing and/or remove the tracheostomy tube can involve multiple surgeries. We seek to understand better the factors that contribute to outcomes for these patients and how we can decrease the number of surgeries required and increase the likelihood of being able to remove the tracheostomy tube if present. This is a collaborative study with Wake Forest and the University of California, Davis.
Recurrent Respiratory Papillomatosis (Heatmap) Study
Disorders: Recurrent Respiratory Papillomatosis
Eligible Subjects: Adult patients with laryngeal papilloma (Recurrent Respiratory Papillomatosis)
Information: This study aims to describe the location of papilloma growth across different regions of the voice box over time and following treatment. Your treating doctor will document papilloma growth and location at each of your regular clinic visits, and collect information on the type and number of surgeries needed to treat your condition. No experimental procedures or extra clinic visits will take place. This study is being done with the NYU Voice Center supporting the innovative RRP mapping technique developed at the NYU Voice Center (Milan Amin, MD).
Cricopharyngeal Dysfunction and Esophageal Diverticulum Prospective, Multi-Institutional Study
Disorders: Zenker’s Diverticulum
Eligible Subjects: Zenker’s Patients
Information: This is a multi-institutional study looking at patients undergoing surgical repair of Zenker’s diverticulum. We hypothesize dysphagia (difficulty swallowing) scores will improve for both endoscopic and open following surgery; however, patients undergoing an open approach will have better long-term dysphagia scores.
Vox95
Disorders: N/A
Eligible Subjects: Singers
Information: This is an observational cross-sectional survey-based study of performing artists at San Francisco Opera House. We are studying to impact of masked singing under the typical singing demands of a professional opera house rehearsal and performance process. Specifically, we are evaluating the changes in perceived vocal effort under this typical professional level vocal load and beginning to understand potential impacts of masked singing on various components of a singer’s technique (breathing, resonance, etc).
Timing of Recurrence in Early Glottic Cancer (T1 and T2): A Multi-Institution Review
Eligible Subjects: N/A
Information: This is a multi-institution retrospective review of patients diagnosed with early glottic cancer (T1 and T2). We are studying patients from UCSF and other academic medical centers over the last 20+ years who have been diagnosed with early-stage squamous cell carcinoma of the vocal folds, and treated with surgery, radiation, chemotherapy, or some combination of those. We are particularly interested in the time interval between treatment and recurrence so that we can build an appropriate and evidence-based surveillance protocol which balances the risk of this cancer recurring and the cost/inconvenience of routine surveillance visits.
SD PROMS
Disorders: Spasmodic dysphonia
Eligible Subjects: Patients with spasmodic dysphonia who receive botulinum toxin treatment
Information: This is a cross-sectional cohort study with a focus on patient reported outcome measures and acoustic analysis. Multiple validated standard questionnaires already used in voice care and treatment alongside new visual analogue scales are being compared over the course of botulinum toxin treatment for both adductor and abductor spasmodic dysphonia with and without essential tremor. In addition, acoustic analysis via a mobile app-based platform is performed to understand changes to acoustic signal during treatment. By evaluating questionnaires concurrently, we hope to understand the strengths and weaknesses of each with regards to both clinical utility and patient preference.
Influence of Angle and Moisture on Tactile Aesthesiometer Force in Laryngopharyngeal Sensory Testing
Disorders: N/A
Eligible Subjects: N/A
Information: Our research team has developed and deployed a novel and validated tool to test sensation in the throat box (see above). The device uses filaments to deliver stimuli at different sites in the throat box. We conducted two experiments to determine the effects of moisture and angle of contact on the filaments. In the laboratory setting, we recorded and measured the force of the filaments on an electronic scale. We tested the filaments at five different angles, dry and saturated in saliva.
Determination of normative value of the Singing Voice Handicap Index-10 (SVHI-10)
Disorders: N/A
Eligible Subjects: Healthy Singers
Information: The Singing Voice Handicap Index-10 (SVHI-10) is a commonly used questionnaire to assess a patient’s perceived voice handicap specifically related to their singing. It is unknown what value should be considered abnormal. By evaluating a large group of singers, we will establish the cutoff for a normal vs. abnormal score. This will improve clinical care for singers with voice problems.
Video Fluoroscopy Modified Barium Swallow Review
Disorders: Patients with Head and Neck Cancer
Eligible Subjects: N/A
Information: Patients who receive radiation treatment for head and neck cancer often see changes in their swallowing ability. We are utilizing UCSF’s electronic health records and special x-ray imaging called the “modified barium swallow study” to quantify changes in swallowing function over time. We hope to find predictors and correlates of swallowing success and decline using data on tumor, treatment, and radiation characteristics.
Preference and Comparison of Patient Reported Outcome Measures in Laryngeal Dystonia
Disorders: All disorders treated with Botox
Eligible Subjects: All patients receiving Botox injections
Information: This is a cross-sectional cohort study looking at patient preferences for various Patient Reported Outcome Measures (PROMs) in those with voice disorders improved by Botox injections. The information gathered will be useful for other clinicians when deciding which questionnaire to administer to patients by making the care they receive more patient-centered.
Comparative Life Cycle Assessment Between Reusable and Disposable Laryngoscopes
Disorders: N/A
Eligible subjects: N/A
Information: We are aiming to quantify and compare the environmental impacts between reusable and disposable flexible laryngoscopes, a specialized camera used to visualize the voice box. We hope to measure greenhouse gas emissions, water consumption, and energy usage during the production, reprocessing, and disposal processes of the scopes. This novel research will help inform healthcare providers and facilities in their choice of laryngoscopes.
Publications
Association Between Quality of Life Questionnaires in Patients Seen at a Voice and Swallowing Center
Disorders: Airway, Voice and Swallowing
Eligible Subjects: Any patient with an airway, voice or swallowing condition
Information: Laryngology outcomes focus primarily on patient reported outcome measures (PROMs). Increasing the number of questionnaires leads to survey fatigue and reliability of patient responses. We are looking to determine overlaps and redundancies between the current questionnaires given to patients seen at our Voice and Swallowing Center.
Using Qualitative Electromyography to Guide Botulinum Toxin Injection for Spasmodic Dysphonia
Disorders: Abductor Spasmodic Dysphonia
Eligible Subjects: Adult patients with abductor spasmodic dysphonia who seek Botox treatment
Information: EMG is a tool used by laryngologists to inject Botox for the treatment of spasmodic dysphonia. Currently, EMG is used qualitatively (based on how the signal “sounds”). We are investigating using EMG quantitatively (based on the numbers and data generated by the EMG machine) to more accurately and consistently inject Botox for our SD patients. This method will especially help less experienced Botox injectors.
Creation and Implementation of a Laryngologic Symptom Diary for Trial Vocal Fold Injection
Disorders: Vocal Fold Atrophy, Scar, Paresis, Sulcus, Essential Tremor, Cricoarytenoid Joint Fixation, Chronic Cough
Eligible Subjects: Adult patients with various Voice disorders undergoing trial vocal fold injection augmentation
Information: Certain voice conditions are difficult to treat, and one potential treatment option is a trial vocal fold augmentation. A temporary gel filler is injected into the vocal fold(s), and the patient is reports back to the physician after 4-12 weeks how much their voice improved with the injection. We have created and are validating a “Voice Diary” to assist patients in documenting and tracking the aspects of their voice that change following this trial injection. This will help decision making by enhancing accuracy of patient recall.
Abstract Factors Predicting the Likelihood of Subsequent Research Publication
This study is completed. Pubmed link
Observations and Considerations for Implementing Remote Acoustic Voice Recording and Analysis in Clinical Practice
This study is completed. Pubmed link
Application of Speech Handicap Index (SHI) in patients after Total Laryngectomy in America and SHI Item Reduction [Fulbright Scholar’s Project]
This study is completed. Pubmed link
Superior Laryngeal Nerve Block for the Treatment of Unexplained Chronic Cough
Disorders: Chronic Cough
Eligible Subjects: Adult patients with cough (greater than 3 months total duration) not adequately controlled with medications or cough therapy
Information: Chronic cough is a bothersome symptom. Sometimes, despite many investigations, specialist referrals, and medication trials/therapies, the cough persists. This is called unexplained chronic cough. We are investigating the use of a novel treatment option called a superior laryngeal nerve block. With this procedure, a steroid-lidocaine injection around the nerve controlling sensation to the voice box is performed.
Utility of Alginate Therapy in the Treatment of Laryngopharyngeal Reflux Disease
Disorders: Laryngopharyngeal Reflux Disease
Eligible Subjects: Adult patients with Laryngopharyngeal Reflux Disease looking to avoid long term PPI use
Information: Acid reflux can cause a variety of throat related symptoms including hoarseness, throat clearing, foreign body sensation, increased mucous, cough, and sore throat. Proton Pump Inhibitors (PPIs) are effective treatment options for this disorder, but some patients wish to avoid long term use or wean off the PPI. We are exploring patients experience with the use of Alginates (a natural seaweed product) in treating their reflux condition.
Podium Presentations
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Young VN, Ma Y, Rosen CA, Schneider SL. Medicare Restriction of Telehealth Speech Services Negatively Impacts Patient Care.
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Zhao NW, MacDonald BV, Pietrowski JR, Laus J, Evangelista LM, Joseph I, Rosen CA, Belafsky PC. Clinician Accuracy in Identifying Essential Laryngeal Landmarks on Swallowing Fluoroscopy.
Poster Presentations
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Laohakittikul C, Kaur Khalsa I, Rao SJ, Madden LM, Cates DC, Young VN. Age in Glottic versus Multi-Level Airway Stenosis: a Multi-Institutional Review.
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Fakurnejad S, Shuman EA, Lappin JJ, Young VN, Rosen CA. A Modern Perspective on Direct Laryngoscopy: Surgeon Preferences and Future Directions.
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Laohakittikul C, Gochman GE, Young VN, Schneider SL. Gender Affirming Voice Therapy Duration and Satisfaction.
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Truong B, Lappin JJ, Perrin CE, Ma Y, Rosen CA, Young VN. Tolerance, Safety, and Perceptions of Awake Esophageal and Airway Dilations.