{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T01:32:38Z","timestamp":1767922358197,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T00:00:00Z","timestamp":1426550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study examined the effects of a topical vocal fold hydration treatment on voice production over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective, longitudinal, within\u2010subjects A (baseline), B (treatment), A (withdrawal\/reversal), B (treatment) experimental design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eight individuals with primary Sj\u00f6gren's syndrome (SS), an autoimmune disease causing laryngeal dryness, completed an 8\u2010week A\u2010B\u2010A\u2010B experiment. Participants performed twice\u2010daily audio recordings of connected speech and sustained vowels and then rated vocal effort, mouth dryness, and throat dryness. Two\u2010week treatment phases introduced twice\u2010daily 9\u2010mL doses of nebulized isotonic saline (0.9% Na<jats:sup>+<\/jats:sup>Cl<jats:sup>\u2212<\/jats:sup>). Voice handicap and patient\u2010based measures of SS disease severity were collected before and after each 2\u2010week phase. Connected speech and sustained vowels were analyzed using the Cepstral Spectral Index of Dysphonia (CSID). Acoustic and patient\u2010based ratings during each baseline and treatment phase were analyzed and compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline CSID and patient\u2010based ratings were in the mild\u2010to\u2010moderate range. CSID measures of voice severity improved by approximately 20% with nebulized saline treatment and worsened during treatment withdrawal. Posttreatment CSID values fell within the normal\u2010to\u2010mild range. Similar patterns were observed in patient\u2010based ratings of vocal effort and dryness. CSID values and patient\u2010based ratings correlated significantly (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Nebulized isotonic saline improves voice production based on acoustic and patient\u2010based ratings of voice severity. Future work should optimize topical vocal fold hydration treatment formulations, dose, and delivery methodologies for various patient populations. This study lays the groundwork for future topical vocal fold hydration treatment development to manage and possibly prevent dehydration\u2010related voice disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2b. <jats:italic>Laryngoscope<\/jats:italic>, 125:2333\u20132340, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25239","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T06:09:13Z","timestamp":1426572553000},"page":"2333-2340","source":"Crossref","is-referenced-by-count":21,"title":["Nebulized isotonic saline improves voice production in <scp>S<\/scp>j\u00f6gren's syndrome"],"prefix":"10.1002","volume":"125","author":[{"given":"Kristine","family":"Tanner","sequence":"first","affiliation":[{"name":"Department of Communication Disorders Brigham Young University, Provo; the Division of Rheumatology Salt Lake City Utah U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn L.","family":"Nissen","sequence":"additional","affiliation":[{"name":"Department of Communication Disorders Brigham Young University, Provo; the Division of Rheumatology Salt Lake City Utah U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ray M.","family":"Merrill","sequence":"additional","affiliation":[{"name":"Department of Health Science Brigham Young University, Provo; the Division of Rheumatology Salt Lake City, Utah U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Miner","sequence":"additional","affiliation":[{"name":"Department of Communication Disorders Brigham Young University, Provo; the Division of Rheumatology Salt Lake City Utah U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron W.","family":"Channell","sequence":"additional","affiliation":[{"name":"Department of Communication Disorders Brigham Young University, Provo; the Division of Rheumatology Salt Lake City Utah U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla L.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Health Science Brigham Young University, Provo; the Division of Rheumatology Salt Lake City, Utah U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Elstad","sequence":"additional","affiliation":[{"name":"Division of Respiratory Critical Care and Occupational Pulmonary Medicine Salt Lake City Utah U.S.A."},{"name":"George E. 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