{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T08:16:03Z","timestamp":1782029763690,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objective\/Hypothesis<\/jats:title><jats:p>The objective of this study was to investigate the glottic gap area as a significant marker for the severity of presbyphonia as it relates to patient\u2010reported outcome measures (Voice Handicap Index\u201010 [VHI\u201010]) and stroboscopic findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case\u2010control study conducted in an academic tertiary voice center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients seen at a tertiary voice clinic who were diagnosed with presbyphonia without other organic laryngeal pathology from January 2014 to December 2017 were included. Clinical data and laryngeal videostroboscopy videos were collected. Still images at the point of vocal process approximation during adduction were captured, and the glottic gap area was measured using ImageJ. These were compared to a control cohort. Correlations were made using Wilcoxon rank sum test, Mann\u2013Whitney U test, and Pearson correlation coefficients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010three patients were included. Inter\u2010rater reliability of glottic area measurement was strong (intraclass correlation coefficient\u00a0=\u20090.73, <jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001). Compared to controls, presbyphonia patients had a larger glottic gap area (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001) and greater open\u2010phase quotient on laryngeal videostroboscopy (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001). Larger glottic gap area did not correlate with patient\u2010reported vocal function as measured by VHI\u201010 (<jats:italic>P<\/jats:italic>\u00a0=\u2009.79) and did not correlate with presence of secondary muscle tension dysphonia (<jats:italic>P<\/jats:italic>\u00a0=\u2009.99). In the presbyphonia cohort, the glottic gap area did not correlate with age (<jats:italic>P<\/jats:italic>\u00a0=\u2009.29).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Glottic gap area at the point of vocal process approximation during phonation can be reliably measured. Patients with presbyphonia have a larger glottic gap area and greater open\u2010phase quotient on stroboscopy, but these do not correlate with patient\u2010reported voice impairment or the presence of secondary muscle tension dysphonia (MTD). These data suggest that dysphonia severity in presbyphonia is not fully explained by a glottic gap or secondary MTD alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:1594\u20131598, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29068","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T18:27:34Z","timestamp":1600972054000},"page":"1594-1598","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Correlation of Glottic Gap and Voice Impairment in Presbyphonia"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5735-1843","authenticated-orcid":false,"suffix":"Jr","given":"Patrick O.","family":"McGarey","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia Health System  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Bitar","sequence":"additional","affiliation":[{"name":"Long School of Medicine University of Texas Health Science Center  San Antonio Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte K.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Brooke Army Medical Center  Fort Sam Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Hodson","sequence":"additional","affiliation":[{"name":"Long School of Medicine University of Texas Health Science Center  San Antonio Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward A.","family":"Harris","sequence":"additional","affiliation":[{"name":"Long School of Medicine University of Texas Health Science Center  San Antonio Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0122-276X","authenticated-orcid":false,"given":"Laura M.","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology UT Health Science Center San Antonio  San Antonio Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4389-3104","authenticated-orcid":false,"given":"Gregory R","family":"Dion","sequence":"additional","affiliation":[{"name":"Dental and Craniofacial Trauma Research Department U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston  San Antonio Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Blake","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00915.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3180306da1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199202000-00007"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13559"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22397"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115710"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940311201012"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814544673"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949710600109"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816637081"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0047-6374(82)90031-8"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25398"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2016.06.008"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215118001573"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1980.00790270013003"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12725"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20890"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199603001-00001"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.128894"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2018.04.006"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949210100307"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200111000-00029"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000150701.46377.df"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T19:39:37Z","timestamp":1693424377000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,9]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1002\/lary.29068"],"URL":"https:\/\/doi.org\/10.1002\/lary.29068","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,9]]},"assertion":[{"value":"2020-03-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}