{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T21:41:48Z","timestamp":1785793308952,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T00:00:00Z","timestamp":1571788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01 DC014538\u201001"],"award-info":[{"award-number":["R01 DC014538\u201001"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Most type 1 thyroplasty implants and some common injectable materials are mechanically stiff. Placing them close to the supple vocal fold mucosa can potentially dampen vibration and adversely impact phonation, yet this effect has not been systematically investigated. This study aims to examine the effect of implant depth on vocal fold vibration and vocal output.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Computational simulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Voice production was simulated with a fiber\u2010gel finite element computational model that incorporates a three\u2010layer vocal fold composition (superficial lamina propria, vocal ligament, thyroarytenoid muscle). Implants of various depths were simulated, with a \u201cdeeper\u201d or more medial implant positioned closer to the vocal fold mucosa and replacing more muscle elements. Trajectories of surface and within\u2010tissue nodal points during vibration were produced. Outcome measures were the trajectory radii, fundamental frequency (<jats:styled-content><jats:italic>F<\/jats:italic><jats:sub>0<\/jats:sub><\/jats:styled-content>), sound pressure level (SPL), and smoothed cepstral peak prominence (CPPS) as a function of implant depth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Amplitude of vibration at the vocal fold medial surface was reduced by an implant depth of as little as 14% of the total transverse vocal fold depth. Increase in <jats:styled-content><jats:italic>F<\/jats:italic><jats:sub>0<\/jats:sub><\/jats:styled-content> and decrease in CPPS were noted beyond 30% to 40% implant depth, and SPL decreased beyond 40% to 60% implant depth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Commonly used implants can dampen vibration \u201cfrom a distance,\u201d ie, even without being immediately adjacent to vocal fold mucosa. Since implants are typically placed at depths examined in this study, stiff implants likely have a negative vocal impact in a subset of patients. Softer materials may be preferable, especially in bilateral medialization procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>N\/A <jats:italic>Laryngoscope<\/jats:italic>, 130:2192\u20132198, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28365","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T19:26:46Z","timestamp":1571858806000},"page":"2192-2198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effect of Vocal Fold Implant Placement on Depth of Vibration and Vocal Output"],"prefix":"10.1002","volume":"130","author":[{"given":"Simeon L.","family":"Smith","sequence":"first","affiliation":[{"name":"National Center for Voice and Speech University of Utah  Salt Lake City Utah U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo R.","family":"Titze","sequence":"additional","affiliation":[{"name":"National Center for Voice and Speech University of Utah  Salt Lake City Utah U.S.A."},{"name":"Department of Communication Sciences and Disorders University of Iowa  Iowa City Iowa U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2187-8181","authenticated-orcid":false,"given":"Claudio","family":"Storck","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Division of Phoniatrics University Hospital Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-6707","authenticated-orcid":false,"given":"Ted","family":"Mau","sequence":"additional","affiliation":[{"name":"Clinical Center for Voice Care Department of Otolaryngology\u2013Head and Neck Surgery, University of Texas Southwestern Medical Center  Dallas Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20816"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.07.003"},{"key":"e_1_2_6_4_1","first-page":"211","volume-title":"Principles of Voice Production","author":"Titze IR","year":"2000"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.5091099"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.1652033"},{"key":"e_1_2_6_7_1","volume-title":"The Myoelastic Aerodynamic Theory of Phonation","author":"Titze IR","year":"2006"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.4900563"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.5001055"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25267"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(89)80003-7"},{"key":"e_1_2_6_12_1","first-page":"183","volume-title":"Vocal Fold Physiology: Biomechanics, Acoustics, and Phonatory Control","author":"Alipour\u2010Haghighi F","year":"1985"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/02699200903242988"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2011\/10-0209)"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941212100808"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940311200406"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.3224706"},{"key":"e_1_2_6_18_1","unstructured":"BoersmaP WeeninkD. 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