Evidence map›Paper›PMID 37865541›Full record

ArticleJournal of voice : official journal of the Voice Foundation2025

Relationships Between Laryngoscopic Analysis Metrics of Supraglottic Compression and Vocal Effort in Primary Muscle Tension Dysphonia.

Adrianna C Shembel, Robert A Morrison, Sarah McDowell, Julianna C Smeltzer, Caroline Crocker, Crystal Bell, Ted Mau

Open access · greenAbstract read
In one paragraph

Article in Journal of voice : official journal of the Voice Foundation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Relationships Between Aerodynamics and Voice Symptoms in Primary Muscle Tension Dysphonia.Journal of voice : official journal of the Voice Foundation · 2025
    Article
  4. Salient Voice Symptoms in Primary Muscle Tension Dysphonia.Journal of voice : official journal of the Voice Foundation · 2025
    Article
  5. Characterization of upper esophageal sphincter pressures relative to vocal acoustics.Journal of applied physiology (Bethesda, Md. : 1985) · 2025
    Article
  6. Laryngeal and Global Somatosensation in Primary Muscle Tension Dysphonia.Journal of voice : official journal of the Voice Foundation · 2024
    Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Adrianna C ShembelSchool of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Dallas, Texas; Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: adrianna.shembel@utdallas.edu.
Robert A MorrisonSchool of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Dallas, Texas.
Sarah McDowellSchool of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Dallas, Texas.
Julianna C SmeltzerSchool of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Dallas, Texas.
Caroline CrockerSchool of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Dallas, Texas.
Crystal BellSchool of Psychological Sciences, Department of Communication Sciences, Case Western Reserve University, Cleveland, Ohio.
Ted MauDepartment of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, Texas.
The University of Texas at Dallas · USCase Western Reserve University · USThe University of Texas Southwestern Medical Center · US

Funding

Novel approaches to the study of laryngeal muscle in functional voice disordersR21DC019207 · NIDCD · UT SOUTHWESTERN MEDICAL CENTER · PI SHEMBEL, ADRIANNA · 2021 to 2023
$492k
NIDCD NIH HHS R21 DC019207
6 · The paper itself

Abstract

purposeSupraglottic compression is thought to underlie vocal effort in patients with primary muscle tension dysphonia (pMTD). However, the relationship between supraglottic compression and vocal effort in this clinical population remains unclear. Gold standard laryngoscopic assessment metrics for supraglottic compression are also lacking. The goals of this study were to identify metrics proposed in the literature that could distinguish patients diagnosed with pMTD from typical voice users and determine their relationships to the vocal effort.

methodsFlexible laryngeal endoscopy was performed on 50 participants (25 pMTD, 25 controls). The presence of supraglottic compression was characterized using a categorical (nominal) scale and severity was quantified on ordinal and continuous scales. The three laryngoscopic metrics were correlated with self-perceived ratings of vocal effort on a 100 mm visual analog scale.

resultsInter-rater reliability was strongest for the continuous scale (P's < 0.0001) compared to categorical (P's < 0.001) and ordinal (P's < 0.001) scales. The presence of different supraglottic compression patterns varied in both groups, and there were no significant group differences on categorical (P's > 0.05) scales. Mediolateral (M-L) supraglottic compression was significantly greater in the pMTD group (P < 0.0001), and anteroposterior (A-P) compression was significantly greater in the control group (P = 0.001) using continuous scales. There were no significant relationships between any of the three laryngoscopic metric types and vocal effort ratings (P's > 0.05), except for a significantly positive relationship between anterior-posterior compression on the ordinal scale and vocal effort in the control group (P = 0.047).

conclusionsContinuous scales are reliable and valid for distinguishing individuals with pMTD from those without voice disorders, especially occupational voice users. M-L supraglottic compression may be a better indicator of pMTD than A-P compression. However, the poor correlation between supraglottic compression and vocal effort suggests that one may not influence the other. Future studies should focus on other mechanisms underlying vocal effort in patients with pMTD.

Indexed as

DysphoniaLaryngeal MusclesLaryngoscopyMuscle TonusPhonationVoice QualityAdultAgedBiomechanical PhenomenaCase-Control StudiesFemaleHumansMaleMiddle AgedObserver VariationPredictive Value of TestsLaryngoscopyMuscle tension dysphoniaVentricular foldsVocal effort

Identifiers

PMID37865541
PMCPMC12915990
OpenAlexW4387784299

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.