{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:24:54Z","timestamp":1782897894344,"version":"3.54.5"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"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":[[2021,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To examine patterns of recurrence of benign phonotraumatic vocal fold lesions over time for insights into pathophysiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with mathematical modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records and stroboscopic exams of adults who underwent microlaryngoscopic resection of phonotraumatic vocal fold lesions over a 13\u2010year period were reviewed for time to recurrence after surgery. Uniform and log\u2010normal probability distributions were fitted to the time to recurrence curves for vocal fold polyps, midfold masses, and pseudocysts. Model fits were compared using the Akaike information criterion corrected, a standard measure of the goodness of fit. Stochastic simulations were used to verify that the mechanistic hypotheses were concordant with the selected probability distributions and empiric data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 567 patients who underwent microlaryngoscopic resection, 65 had a recurrence (16 polyps, 14 midfold masses, and 35 pseudocysts). Midfold mass and pseudocyst recurrences were predominantly seen in younger women. Polyps were best fit by a uniform distribution rather than log\u2010normal, whereas midfold masses and pseudocysts were better fit by log\u2010normal rather than uniform. Stochastic simulations suggest that polyps recur sporadically according to a paroxysmal\u2010developmental model, whereas midfold mass and pseudocyst recurrences follow a force\u2010multiplication, damage\u2010accumulation process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Vocal fold polyps are acute lesions evenly distributed by age and gender that recur uniformly over time, suggesting they arise from sudden tissue reactions to phonotraumatic stress. Pseudocysts and midfold fibrous masses are chronic lesions predominantly found in young women that recur with log\u2010normal distribution over time, suggesting gradual damage accumulation in larynges predisposed to enhanced phonotrauma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:2523\u20132529, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29531","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T12:50:37Z","timestamp":1617972637000},"page":"2523-2529","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Patterns of Recurrence of Phonotraumatic Vocal Fold Lesions Suggest Distinct Mechanisms of Injury"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6643-4360","authenticated-orcid":false,"given":"Mark","family":"Lee","sequence":"first","affiliation":[{"name":"The Sean Parker Institute for the Voice, Department of Otolaryngology\u2010Head &amp; Neck Surgery Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-6707","authenticated-orcid":false,"given":"Ted","family":"Mau","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8989-2073","authenticated-orcid":false,"given":"Lucian","family":"Sulica","sequence":"additional","affiliation":[{"name":"The Sean Parker Institute for the Voice, Department of Otolaryngology\u2010Head &amp; Neck Surgery Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00020840-200312000-00009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22421"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000408"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0863-x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.2005.01074.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1991.tb01933.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.12.009"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100091167"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948209100410"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556130808700202"},{"key":"e_1_2_6_12_1","first-page":"150","article-title":"Pathogenesis and treatment of vocal nodules","volume":"27","author":"Rubin HJ","year":"1962","journal-title":"J Speech Lang Hear Res"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2003.07.003"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1066896911411480"},{"key":"e_1_2_6_15_1","first-page":"376","article-title":"Exudative laryngeal diseases of Reinke's space: a clinicohistopathological framing","volume":"31","author":"Marcotullio D","year":"2002","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24911"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28349"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949810700711"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2003.11.007"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000219952"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26734"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28281"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5193(84)80162-9"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9290(97)00033-X"},{"key":"e_1_2_6_25_1","unstructured":"NIST\/SEMATECH e\u2010Handbook of Statistical Methods. 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