{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T15:29:38Z","timestamp":1793978978857,"version":"4.8.0"},"reference-count":85,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec id=\"ab-ooi240046-4\"><jats:title>Importance<\/jats:title><jats:p>Voice disorders impede communication and detract from quality of life, yet little is known about how voice problems present in adolescents. This study characterized the prevalence of voice problems and vocal health characteristics of adolescents throughout the US.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240046-5\"><jats:title>Objective<\/jats:title><jats:p>To determine the prevalence of adolescent voice problems in the US as well as the symptoms, voice use patterns, and risk factors associated with these problems.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240046-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This prospectively performed, cross-sectional survey study conducted from March to June 2023 included a probability sample of adolescents (aged 13-17 years) who were located across the US.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240046-7\"><jats:title>Main Outcome and Measures<\/jats:title><jats:p>Adolescents were surveyed concerning voice use, voice symptoms, demographic information, and substance use patterns. The Vocal Fatigue Index (VFI) was also completed. Fisher exact tests, \u03c7<jats:sup>2<\/jats:sup> tests, and logistic regression were used to compare those with and without reported voice problems.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240046-8\"><jats:title>Results<\/jats:title><jats:p>Five-hundred and two adolescents participated (51.6% participation rate), including 248 female (49.4%), 7 nonbinary (1.3%), 254 male (50.6%), 4 transfemale (0.7%), and 3 transmale individuals (0.5%) (mean [SD] age, 15.2 [1.3] years). The lifetime prevalence of voice problems was 24.3%, and current prevalence was 7.4%. Voice-related diagnoses included dysphonia associated with acute illness, vocal hyperfunction, benign lesions, and muscle tension. The mean (SD) VFI score was 4.7 (8.09) for part 1, 1.6 (3.2) for part 2, and 2.1 (3.2) for part 3. Adolescents with voice complaints presented with significantly higher VFI scores than those without voice problems (Cohen <jats:italic>d<\/jats:italic> for part 1 = 0.78, part 2 = 0.59, and part 3 = 0.79). Voice problems interfered with daily tasks, prevented participation in extracurricular activities, limited the ability to sing, and were associated with school absences. Voice use patterns associated with voice problems included frequent loud voice use, coughing, and\/or throat clearing. Risk factors for increased voice problem prevalence included part-time employment in childcare (odds ratio [OR], 6.4; 95% CI, 1.6-26.3), singing (OR, 2.08; 95% CI, 1.3-3.1), performance-related extracurricular activities (ie, musical theater [OR, 2.67; 95% CI, 1.1-6.6 ], karaoke [OR, 3.08; 95% CI, 1.3-6.9]), vaping (OR, 1.99; 95% CI, 1.1-3.5), and\/or secondhand smoke exposure (OR, 1.83; 95% CI, 1.2-2.7). Adolescents identifying as transgender were more than 4 times (OR, 4.44; 95% CI, 0.63-31.2) as likely to report voice problems compared with cisgender adolescents.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240046-9\"><jats:title>Conclusions<\/jats:title><jats:p>The results of this survey study illuminate the nature of voice problems in adolescents and may guide clinicians in preventing and treating voice disorders in this population. Future work may define the mechanisms through which these factors are associated with the risk for voice disorders in adolescents and determine whether observed relationships are causal or associative.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2024.2081","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T15:45:20Z","timestamp":1721922320000},"page":"800","source":"Crossref","is-referenced-by-count":22,"title":["Voice Disorder Prevalence and Vocal Health Characteristics in Adolescents"],"prefix":"10.1001","volume":"150","author":[{"given":"Robert Brinton","family":"Fujiki","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Wisconsin\u2013Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Thibeault","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Wisconsin\u2013Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"7","key":"ooi240046r1","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1002\/lary.v122.7","article-title":"The impact of laryngeal disorders on work-related dysfunction.","volume":"122","author":"Cohen","year":"2012","journal-title":"Laryngoscope"},{"issue":"1","key":"ooi240046r2","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/S0167-6393(02)00082-1","article-title":"The role of voice quality in communicating emotion, mood and attitude.","volume":"40","author":"Gobl","year":"2003","journal-title":"Speech Commun"},{"issue":"2","key":"ooi240046r3","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.jvoice.2006.09.005","article-title":"Attitudes of children with dysphonia.","volume":"22","author":"Connor","year":"2008","journal-title":"J Voice"},{"issue":"11","key":"ooi240046r4","doi-asserted-by":"publisher","first-page":"1988","DOI":"10.1097\/01.mlg.0000179174.32345.41","article-title":"Voice disorders in the general population: prevalence, risk factors, and occupational impact.","volume":"115","author":"Roy","year":"2005","journal-title":"Laryngoscope"},{"issue":"5","key":"ooi240046r5","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1044\/2016_JSLHR-S-15-0214","article-title":"Epidemiology of vocal health in young adults attending college in the United States.","volume":"59","author":"Hartley","year":"2016","journal-title":"J Speech Lang Hear Res"},{"issue":"2","key":"ooi240046r6","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1159\/000089610","article-title":"The prevalence and risk factors for occupational voice disorders in teachers.","volume":"58","author":"Sliwinska-Kowalska","year":"2006","journal-title":"Folia Phoniatr Logop"},{"issue":"3","key":"ooi240046r7","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1002\/lio2.v7.3","article-title":"The prevalence and risk factors for perceived voice disorders in public school teachers.","volume":"7","author":"Feng","year":"2022","journal-title":"Laryngoscope Investig Otolaryngol"},{"issue":"1","key":"ooi240046r8","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1080\/14015430119969","article-title":"Review: occupational risks for voice problems.","volume":"26","author":"Verdolini","year":"2001","journal-title":"Logoped Phoniatr Vocol"},{"issue":"2","key":"ooi240046r9","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1044\/jshd.3102.172","article-title":"An incidence study of chronic hoarseness among children.","volume":"31","author":"Baynes","year":"1966","journal-title":"J Speech Hear Disord"},{"issue":"4","key":"ooi240046r10","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1016\/j.jvoice.2005.07.004","article-title":"The prevalence of childhood dysphonia: a cross-sectional study.","volume":"20","author":"Carding","year":"2006","journal-title":"J Voice"},{"issue":"4","key":"ooi240046r11","doi-asserted-by":"publisher","first-page":"165","DOI":"10.3109\/14015439509098744","article-title":"Prevalence of hoarseness in ten-year-old children.","volume":"20","author":"Sederholm","year":"1995","journal-title":"Scand J Logop Phoniatr"},{"issue":"1","key":"ooi240046r12","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/0165-5876(81)90023-9","article-title":"Hoarseness in children: summer camp study.","volume":"3","author":"Casper","year":"1981","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"5","key":"ooi240046r13","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1001\/jamaoto.2019.0066","article-title":"Association between the development of pediatric voice disorders and singing in children\u2019s choir.","volume":"145","author":"Clar\u00f3s","year":"2019","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"2","key":"ooi240046r14","doi-asserted-by":"publisher","first-page":"301.e1","DOI":"10.1016\/j.jvoice.2018.08.017","article-title":"Pediatric dysphonia: a cross-sectional survey of subspecialty and primary care clinics.","volume":"34","author":"Johnson","year":"2020","journal-title":"J Voice"},{"key":"ooi240046r15","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2024.1516","article-title":"Voice disorder prevalence and vocal health characteristics in children.","author":"Fujiki","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"3","key":"ooi240046r16","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1016\/j.jvoice.2021.02.007","article-title":"Examining relationships between GRBAS ratings and acoustic, aerodynamic and patient-reported voice measures in adults with voice disorders.","volume":"37","author":"Fujiki","year":"2023","journal-title":"J Voice"},{"issue":"3","key":"ooi240046r17","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1044\/2018_AJSLP-17-0009","article-title":"Recommended protocols for instrumental assessment of voice: American Speech-Language-Hearing Association expert panel to develop a protocol for instrumental assessment of vocal function.","volume":"27","author":"Patel","year":"2018","journal-title":"Am J Speech Lang Pathol"},{"issue":"5","key":"ooi240046r18","doi-asserted-by":"publisher","first-page":"665.e9","DOI":"10.1016\/j.jvoice.2011.09.010","article-title":"Epidemiology of voice disorders in teachers and nonteachers in Brazil: prevalence and adverse effects.","volume":"26","author":"Behlau","year":"2012","journal-title":"J Voice"},{"issue":"8","key":"ooi240046r19","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1177\/000348941312200806","article-title":"Voice symptoms and voice-related quality of life in college students.","volume":"122","author":"Merrill","year":"2013","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"2","key":"ooi240046r20","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1044\/1092-4388(2004\/023)","article-title":"Prevalence of voice disorders in teachers and the general population.","volume":"47","author":"Roy","year":"2004","journal-title":"J Speech Lang Hear Res"},{"issue":"4","key":"ooi240046r21","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1097\/MLG.0b013e3180306da1","article-title":"Epidemiology of voice disorders in the elderly: preliminary findings.","volume":"117","author":"Roy","year":"2007","journal-title":"Laryngoscope"},{"issue":"10","key":"ooi240046r22","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1016\/j.annepidem.2004.03.004","article-title":"Occupational risk factors associated with voice disorders among teachers.","volume":"14","author":"Thibeault","year":"2004","journal-title":"Ann Epidemiol"},{"issue":"4","key":"ooi240046r23","doi-asserted-by":"publisher","first-page":"1665","DOI":"10.1044\/2023_AJSLP-22-00390","article-title":"Examining therapy duration in adults with voice disorders.","volume":"32","author":"Fujiki","year":"2023","journal-title":"Am J Speech Lang Pathol"},{"issue":"3","key":"ooi240046r24","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/BF02993116","article-title":"Effects of vocal fatigue on voice parameters of Indian teachers.","volume":"54","author":"Sivasankar","year":"2002","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"issue":"1","key":"ooi240046r25","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1111\/jora.2011.21.issue-1","article-title":"Puberty and its measurement: a decade in review.","volume":"21","author":"Dorn","year":"2011","journal-title":"J Res Adolesc"},{"issue":"3","key":"ooi240046r26","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1044\/jshr.2503.446","article-title":"Growth of the human prepubertal and pubertal larynx.","volume":"25","author":"Kahane","year":"1982","journal-title":"J Speech Hear Res"},{"issue":"5","key":"ooi240046r28","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1136\/adc.77.5.445","article-title":"Changes in the male voice at puberty.","volume":"77","author":"Harries","year":"1997","journal-title":"Arch Dis Child"},{"issue":"5","key":"ooi240046r29","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1159\/000094566","article-title":"Voice complaints, risk factors for voice problems and history of voice problems in relation to puberty in female student teachers.","volume":"58","author":"Thomas","year":"2006","journal-title":"Folia Phoniatr Logop"},{"issue":"11","key":"ooi240046r30","doi-asserted-by":"publisher","first-page":"2255","DOI":"10.1007\/s10964-019-01110-2","article-title":"Benefits of extracurricular participation in early adolescence: associations with peer belonging and mental health.","volume":"48","author":"Oberle","year":"2019","journal-title":"J Youth Adolesc"},{"issue":"3","key":"ooi240046r31","doi-asserted-by":"publisher","first-page":"392.e1","DOI":"10.1016\/j.jvoice.2016.10.001","article-title":"Speech adjustments for room acoustics and their effects on vocal effort.","volume":"31","author":"Bottalico","year":"2017","journal-title":"J Voice"},{"issue":"12","key":"ooi240046r32","doi-asserted-by":"publisher","first-page":"2732","DOI":"10.1002\/lary.v131.12","article-title":"Mitigating the effects of acute vocal exertion in individuals with vocal fatigue.","volume":"131","author":"Fujiki","year":"2021","journal-title":"Laryngoscope"},{"issue":"5","key":"ooi240046r33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0268324","article-title":"The effects of vocal exertion on lung volume measurements and acoustics in speakers reporting high and low vocal fatigue.","volume":"17","author":"Fujiki","year":"2022","journal-title":"PLoS One"},{"issue":"11","key":"ooi240046r34","doi-asserted-by":"publisher","first-page":"E674","DOI":"10.1002\/lary.v130.11","article-title":"The therapeutic effects of straw phonation on vocal fatigue.","volume":"130","author":"Kang","year":"2020","journal-title":"Laryngoscope"},{"issue":"2","key":"ooi240046r35","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1044\/0161-1461(2006\/012)","article-title":"Effects of prolonged loud reading on normal adolescent male voices.","volume":"37","author":"Kelchner","year":"2006","journal-title":"Lang Speech Hear Serv Sch"},{"issue":"0","key":"ooi240046r36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2022.12.024","article-title":"The effects of room acoustics on self-reported vocal fatigue: a systematic review.","volume":"0","author":"Nudelman","year":"2023","journal-title":"J Voice"},{"issue":"205","key":"ooi240046r37","first-page":"1","article-title":"Communication disorders and use of intervention services among children aged 3-17 years: United States, 2012.","author":"Black","year":"2015","journal-title":"NCHS Data Brief"},{"issue":"3","key":"ooi240046r38","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1002\/lary.v125.3","article-title":"The prevalence of pediatric voice and swallowing problems in the United States.","volume":"125","author":"Bhattacharyya","year":"2015","journal-title":"Laryngoscope"},{"issue":"9","key":"ooi240046r39","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1002\/lary.v127.9","article-title":"Voice disorders and associated risk markers among young adults in the United States.","volume":"127","author":"Bainbridge","year":"2017","journal-title":"Laryngoscope"},{"issue":"5","key":"ooi240046r40","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.jvoice.2013.03.008","article-title":"Collision and phonation threshold pressures before and after loud, prolonged vocalization in trained and untrained voices.","volume":"27","author":"Enflo","year":"2013","journal-title":"J Voice"},{"issue":"2","key":"ooi240046r41","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.jvoice.2016.07.005","article-title":"The interaction of surface hydration and vocal loading on voice measures.","volume":"31","author":"Fujiki","year":"2017","journal-title":"J Voice"},{"issue":"3","key":"ooi240046r42","doi-asserted-by":"publisher","first-page":"388.e33","DOI":"10.1016\/j.jvoice.2016.09.019","article-title":"A review of vocal loading tasks in the voice literature.","volume":"31","author":"Fujiki","year":"2017","journal-title":"J Voice"},{"issue":"1","key":"ooi240046r43","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.jvoice.2004.05.002","article-title":"Loud speech in realistic environmental noise: phonetogram data, perceptual voice quality, subjective ratings, and gender differences in healthy speakers.","volume":"19","author":"S\u00f6dersten","year":"2005","journal-title":"J Voice"},{"issue":"5","key":"ooi240046r44","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.jvoice.2015.06.012","article-title":"Do talkativeness and vocal loudness correlate with laryngeal pathology? a study of the vocal overdoer\/underdoer continuum.","volume":"30","author":"Bastian","year":"2016","journal-title":"J Voice"},{"issue":"12","key":"ooi240046r45","doi-asserted-by":"publisher","first-page":"3466","DOI":"10.1002\/ppul.v58.12","article-title":"Factors influencing behavioral cough suppression therapy in children with nonspecific chronic cough.","volume":"58","author":"Fujiki","year":"2023","journal-title":"Pediatr Pulmonol"},{"issue":"2","key":"ooi240046r46","doi-asserted-by":"publisher","first-page":"290.e7","DOI":"10.1016\/j.jvoice.2020.05.026","article-title":"Strain elastosonography measurement in patients with primary muscle tension dysphonia compared with healthy speakers: a pilot study.","volume":"36","author":"Azizi Ata","year":"2022","journal-title":"J Voice"},{"issue":"5","key":"ooi240046r47","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1044\/2022_JSLHR-21-00575","article-title":"Integrative review and framework of suggested mechanisms in primary muscle tension dysphonia.","volume":"65","author":"Desjardins","year":"2022","journal-title":"J Speech Lang Hear Res"},{"issue":"4","key":"ooi240046r48","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1080\/17549500802140153","article-title":"Current knowledge, controversies and future directions in hyperfunctional voice disorders.","volume":"10","author":"Oates","year":"2008","journal-title":"Int J Speech Lang Pathol"},{"issue":"2","key":"ooi240046r49","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.jvoice.2009.10.009","article-title":"Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge.","volume":"25","author":"Van Houtte","year":"2011","journal-title":"J Voice"},{"issue":"8","key":"ooi240046r50","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1177\/000348941212100808","article-title":"Spectral- and cepstral-based acoustic features of dysphonic, strained voice quality.","volume":"121","author":"Lowell","year":"2012","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"2","key":"ooi240046r51","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/S0892-1997(02)00093-0","article-title":"A pilot survey of vocal health in young singers.","volume":"16","author":"Tepe","year":"2002","journal-title":"J Voice"},{"issue":"6","key":"ooi240046r52","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1016\/j.jvoice.2017.02.010","article-title":"Prevalence of voice disorders in singers: systematic review and meta-analysis.","volume":"31","author":"Pestana","year":"2017","journal-title":"J Voice"},{"issue":"6","key":"ooi240046r53","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1016\/j.jvoice.2013.06.010","article-title":"Quantitative high-speed laryngoscopic analysis of vocal fold vibration in fatigued voice of young karaoke singers.","volume":"27","author":"Yiu","year":"2013","journal-title":"J Voice"},{"issue":"2","key":"ooi240046r54","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/S0892-1997(03)00038-9","article-title":"Effect of hydration and vocal rest on the vocal fatigue in amateur karaoke singers.","volume":"17","author":"Yiu","year":"2003","journal-title":"J Voice"},{"issue":"2","key":"ooi240046r55","doi-asserted-by":"publisher","first-page":"292.e1","DOI":"10.1016\/j.jvoice.2020.05.019","article-title":"Vocal quality, symptoms, and habits in musical theater actors.","volume":"36","author":"D\u2019haeseleer","year":"2022","journal-title":"J Voice"},{"issue":"9","key":"ooi240046r56","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1002\/lary.v133.9","article-title":"Vocal fold pathologies among undergraduate singing students in three different genres.","volume":"133","author":"Bretl","year":"2023","journal-title":"Laryngoscope"},{"issue":"7","key":"ooi240046r57","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1002\/lary.v133.7","article-title":"Association of genre of singing and phonotraumatic vocal fold lesions in singers.","volume":"133","author":"Childs","year":"2023","journal-title":"Laryngoscope"},{"issue":"11","key":"ooi240046r59","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165337","article-title":"Association between second-hand smoking and laryngopathy in the general population of South Korea.","volume":"11","author":"Byeon","year":"2016","journal-title":"PLoS One"},{"issue":"11","key":"ooi240046r60","doi-asserted-by":"publisher","first-page":"2530","DOI":"10.1002\/lary.v131.11","article-title":"Mainstream cigarette smoke impacts the mouse vocal fold epithelium and mucus barrier.","volume":"131","author":"Erickson-DiRenzo","year":"2021","journal-title":"Laryngoscope"},{"issue":"3","key":"ooi240046r61","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1002\/lary.v121.3","article-title":"The effects of cigarette smoke condensate on vocal fold transepithelial resistance and inflammatory signaling in vocal fold fibroblasts.","volume":"121","author":"Branski","year":"2011","journal-title":"Laryngoscope"},{"issue":"6","key":"ooi240046r62","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1016\/j.jvoice.2017.09.006","article-title":"The effects of exposure to environmental cigarette smoke on the vocal folds of rats.","volume":"32","author":"Babalik","year":"2018","journal-title":"J Voice"},{"issue":"8","key":"ooi240046r63","doi-asserted-by":"publisher","DOI":"10.1242\/dmm.049476","article-title":"Exposure to e-cigarette vapor extract induces vocal fold epithelial injury and triggers intense mucosal remodeling.","volume":"15","author":"Lungova","year":"2022","journal-title":"Dis Model Mech"},{"issue":"1","key":"ooi240046r64","doi-asserted-by":"publisher","first-page":"4161","DOI":"10.1038\/s41467-019-12069-w","article-title":"Human induced pluripotent stem cell-derived vocal fold mucosa mimics development and responses to smoke exposure.","volume":"10","author":"Lungova","year":"2019","journal-title":"Nat Commun"},{"issue":"1","key":"ooi240046r65","doi-asserted-by":"publisher","first-page":"4720","DOI":"10.1038\/s41598-020-61565-3","article-title":"Evaluating the effects of smoking on the voice and subjective voice problems using a meta-analysis approach.","volume":"10","author":"Byeon","year":"2020","journal-title":"Sci Rep"},{"issue":"3","key":"ooi240046r66","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1044\/jshd.5503.526","article-title":"Description of laryngeal pathologies in children evaluated by otolaryngologists.","volume":"55","author":"Dobres","year":"1990","journal-title":"J Speech Hear Disord"},{"issue":"4","key":"ooi240046r67","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/j.ijporl.2003.11.005","article-title":"The prevalence of vocal fold nodules in school age children.","volume":"68","author":"Akif Kili\u00e7","year":"2004","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"6","key":"ooi240046r68","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1016\/j.jvoice.2018.07.007","article-title":"Prevalence of voice disorders in the general population, based on the Stockholm Public Health Cohort.","volume":"33","author":"Lyberg-\u00c5hlander","year":"2019","journal-title":"J Voice"},{"issue":"5","key":"ooi240046r69","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1017\/S0022215100140757","article-title":"Changes in the male voice at puberty: vocal fold length and its relationship to the fundamental frequency of the voice.","volume":"112","author":"Harries","year":"1998","journal-title":"J Laryngol Otol"},{"issue":"3","key":"ooi240046r70","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/s00276-008-0307-8","article-title":"Measurements of pre- and postpubertal human larynx: a cadaver study.","volume":"30","author":"Wysocki","year":"2008","journal-title":"Surg Radiol Anat"},{"issue":"4","key":"ooi240046r71","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1097\/MLG.0b013e31802ffe17","article-title":"Concentration and distribution of hyaluronic acid in human vocal folds.","volume":"117","author":"Lebl","year":"2007","journal-title":"Laryngoscope"},{"issue":"5","key":"ooi240046r72","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1097\/00005537-200105000-00029","article-title":"Gender-related differences of hyaluronic acid distribution in the human vocal fold.","volume":"111","author":"Butler","year":"2001","journal-title":"Laryngoscope"},{"issue":"6","key":"ooi240046r73","doi-asserted-by":"publisher","first-page":"761.e1","DOI":"10.1016\/j.jvoice.2015.09.017","article-title":"Voice disorders: etiology and diagnosis.","volume":"30","author":"Martins","year":"2016","journal-title":"J Voice"},{"issue":"2","key":"ooi240046r74","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1159\/000354673","article-title":"Speaking fundamental frequency and phonation time during work and leisure time in vocally healthy preschool teachers measured with a voice accumulator.","volume":"65","author":"Szabo Portela","year":"2013","journal-title":"Folia Phoniatr Logop"},{"issue":"6","key":"ooi240046r75","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1007\/s00405-020-05791-5","article-title":"The impact of a standardized vocal loading test on vocal fold oscillations.","volume":"277","author":"Echternach","year":"2020","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"7","key":"ooi240046r76","doi-asserted-by":"publisher","first-page":"2472","DOI":"10.1044\/2021_JSLHR-20-00713","article-title":"Restoration strategies following short-term vocal exertion in healthy young adults.","volume":"64","author":"Fujiki","year":"2021","journal-title":"J Speech Lang Hear Res"},{"issue":"6","key":"ooi240046r77","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1177\/000348940911800608","article-title":"Quantifying vocal fatigue recovery: dynamic vocal recovery trajectories after a vocal loading exercise.","volume":"118","author":"Hunter","year":"2009","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"3","key":"ooi240046r78","doi-asserted-by":"publisher","first-page":"392.e13","DOI":"10.1016\/j.jvoice.2016.10.002","article-title":"A Systematic review of voice therapy: what \u201ceffectiveness\u201d really implies.","volume":"31","author":"Desjardins","year":"2017","journal-title":"J Voice"},{"issue":"5","key":"ooi240046r79","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/j.jvoice.2006.10.005","article-title":"Effects of voice therapy: a systematic review.","volume":"22","author":"Speyer","year":"2008","journal-title":"J Voice"},{"issue":"2","key":"ooi240046r81","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1044\/2015_AJSLP-14-0030","article-title":"A taxonomy of voice therapy.","volume":"24","author":"Van Stan","year":"2015","journal-title":"Am J Speech Lang Pathol"},{"issue":"6","key":"ooi240046r82","doi-asserted-by":"publisher","first-page":"2663","DOI":"10.1044\/2022_AJSLP-22-00111","article-title":"Pediatric voice therapy: how many sessions to discharge?","volume":"31","author":"Fujiki","year":"2022","journal-title":"Am J Speech Lang Pathol"},{"issue":"4","key":"ooi240046r83","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1002\/lary.v133.4","article-title":"Voice therapy improves acoustic and auditory-perceptual outcomes in children.","volume":"133","author":"Fujiki","year":"2023","journal-title":"Laryngoscope"},{"issue":"4","key":"ooi240046r84","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1080\/14417040701730990","article-title":"Vocal fatigue and its relation to vocal hyperfunction.","volume":"10","author":"Solomon","year":"2008","journal-title":"Int J Speech Lang Pathol"},{"issue":"1","key":"ooi240046r85","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/S0892-1997(03)00033-X","article-title":"Vocal fatigue: current knowledge and future directions.","volume":"17","author":"Welham","year":"2003","journal-title":"J Voice"},{"key":"ooi240046r27","first-page":"243","volume-title":"Information Technology in Biomedicine. Advances in Intelligent Systems and Computing","author":"Bugdol","year":"2019"},{"key":"ooi240046r80","volume-title":"Voice Therapy: Clinical Case Studies","author":"Stemple","year":"2019","edition":"5th ed"},{"key":"ooi240046r58","doi-asserted-by":"crossref","unstructured":"Gonsalves? A, Amin? E, Behlau? M. Overall voice and strain level analysis in rock singers.? Pr\u00f3-Fono R Atual Cient. 2010;22(3):195-200. doi:10.1590\/S0104-56872010000300007","DOI":"10.1590\/S0104-56872010000300007"}],"container-title":["JAMA Otolaryngology\u2013Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/articlepdf\/2821569\/jamaotolaryngology_fujiki_2024_oi_240046_1724860400.29441.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T15:27:56Z","timestamp":1726154876000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/fullarticle\/2821569"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,1]]},"references-count":85,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoto.2024.2081","relation":{},"ISSN":["2168-6181"],"issn-type":[{"value":"2168-6181","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9,1]]}}}