UCSF Voice & Swallowing Center Presentations

Title: Sustainability in Otolaryngology: A Comparison of Environmental Impacts Between Reusable and Disposable Flexible Laryngoscopes

Authors: Kidane J, Thiel CL, Wang K, Rosen CA, Gandhi S

Title: Preoperative acetaminophen for microlaryngoscopy reduces postoperative opioid use

Authors: Lagos-Villaseca A, Lappin JJ, Perrin CE, Ma Y, Young VN, Pasvankas GW, Stockton SD, Rosen CA, Laohakittikul C.

Title: Prospective Assessment of Patient Safety, Tolerance and Perceptions of Awake Airway and Esophageal Dilation

Authors: Young VN, Truong B, Lappin JJ, Perrin CE, Stockton SD, Rosen CA, Ma Y

Title: Follow-up trends in patients undergoing Wendler glottoplasty

Authors: Bowers ID, Crosby TW, Ma Y, Rosen CA, Schneider SL, Young VN

Title: Outcomes and observations in posterior pharyngeal wall injection augmentation for adults with velopharyngeal insufficiency

Authors: Arora N, Young VN, Ma Y, Rosen CA, Crosby TW

Title: Prospective Determination of the Minimal Clinically Important Difference (MCID) of the Singing Voice Handicap Index-10 (SVHI-10)

Authors: Perrin CE, Young VN, Ma Y, Rosen CA, Stockton SD, Schneider SL

Title: ABEA podium - Long-term Swallow Physiology In Head And Neck Cancer Survivors After Radiotherapy: An Objective Quantitative Analysis

Authors: Joseph Kidane MD1 Cara Evans MM, MS CCC-SLP, Rohith Bhethanabotla MS2, Claire E. Perrin BS, Inderpreet Kaur Khalsa MS, James J. Lappin BA, Sarah L. Schneider MS, CCC-SLP, VyVy N. Young MD, Clark A. Rosen MD, Patrick Ha MD, Jason W. Chan MD, Sue S. Yom MD PhD, John Boscardin PhD, William R. Ryan MD, Yue Ma MD

Title: AHNS podium - Swallow Watch: an Automated Dysphagia Alert Program for Patients with Head and Neck Cancer Treated with Radiotherapy 

Authors: Yue Ma MD, Joseph Kidane MD, Claire Perrin BS, Jason W. Chan MD, Preet Hayer, VyVy Young MD, Clark Rosen MD, William R. Ryan MD, Cara Evans MS, CCC-SLP, James Lappin BA, Tyler Crosby MD, Sue S. Yom MD PhD, Sky Yang MS, CCC-SLP, Brittany Mitchell MS, CCC-SLP, Erik Steele MFA MA, CCC-SLP, Lois Chen MS, CCC-SLP, Desi Guiterrez MA, CCC-SLP, Trina Sheedy MMS, PA-C, Mary Xu MD, Kathryn Wai MD, Jonathan George MD, Chase Heaton MD, Ivan El-Sayed MD, Andrea Park MD, Daniel Knott MD, Hyunseok Kang MD, Alain Algazi MD, Amelia Komp NP, MSN, Christine Kim MS, RN, Brittnay Dingler MHS, PA-C, Sarah L. Schneider MS, CCC-SLP, Patrick Ha MD  


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

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

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.

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.

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.

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).

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.

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).

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.

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.

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.

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.

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.

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.

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.


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.

Pubmed link

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.

Pubmed link

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.

Pubmed link

This study is completed. Pubmed link

This study is completed. Pubmed link

This study is completed. Pubmed link

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.

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.

Young VN, Ma Y, Rosen CA, Schneider SL. Medicare Restriction of Telehealth Speech Services Negatively Impacts Patient Care.

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.

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.

Fakurnejad S, Shuman EA, Lappin JJ, Young VN, Rosen CA. A Modern Perspective on Direct Laryngoscopy: Surgeon Preferences and Future Directions.

Laohakittikul C, Gochman GE, Young VN, Schneider SL. Gender Affirming Voice Therapy Duration and Satisfaction.

Truong B, Lappin JJ, Perrin CE, Ma Y, Rosen CA, Young VN. Tolerance, Safety, and Perceptions of Awake Esophageal and Airway Dilations.