{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T08:01:10Z","timestamp":1784966470351,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Optimal trafermin dosages and outcome predictors for treating unilateral vocal fold paralysis (UVFP) remain unclear. We aimed to investigate the optimal trafermin dosage and pre\u2010injection factors contributing to voice improvement after intracordal trafermin injection (ITI) for UVFP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records of 198 patients diagnosed with UVFP who received ITI at the Tokyo Voice Center between 2012 and 2024 were retrospectively evaluated. To investigate the effect of ITI on voice improvement prior to trafermin injection, we assessed age, sex, causative diseases, and pre\u2010 and post\u2010injection maximum phonation time (MPT), pitch range (PR), mean flow rate (MFR), and voice handicap index (VHI). Patients were categorized by dosage: low (&lt;\u2009100\u2009\u03bcg), normal (100\u2009\u03bcg), and high (&gt;\u2009100\u2009\u03bcg). The normal, low, and high groups comprised 152, 12, and 34 cases, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following ITI, improvements in the normal, low, and high dosage groups were as follows: MPT (s) (3.03, 3.13, 5.57), PR (ST) (6.82, 4.5, 8.74), MFR (mL\/s) (191.28, 121.02, 409.63), and VHI (score) (21.75, 1.83, 33.45) (with data missing for MFR and VHI in eight and three cases, respectively). Analysis of variance revealed significant improvements in MPT, MFR, and VHI among groups. Dunnett's test showed significantly better outcomes in the high\u2010dosage group compared to normal. Covariance analysis identified pre\u2010injection values and comorbidities as significant predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher trafermin dosage may provide greater and more sustained voice improvement in patients with UVFP. Identifying optimal candidates based on pre\u2010injection factors can allow for more personalized treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70220","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T11:35:20Z","timestamp":1761219320000},"page":"1425-1432","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Investigation of Optimal Trafermin Dosage and Pre\u2010Injection Factors in Vocal Fold Paralysis"],"prefix":"10.1002","volume":"136","author":[{"given":"Tomohiro","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Tokyo Voice Center International University of Health and Welfare  Tokyo Japan"},{"name":"Department of Epidemiology and Social Medicine, Graduate School of Public Health International University of Health and Welfare  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Tokyo Voice Center International University of Health and Welfare  Tokyo Japan"},{"name":"School of Medicine International University of Health and Welfare  Narita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25715"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2015.09.018"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.806"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2017.1314550"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.5112\/jjlp.66.185"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.04.031"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-023-08165-9"},{"key":"e_1_2_11_9_1","article-title":"Effect of Aging on Vocal Outcomes After Laryngeal Reinnervation Combined With Arytenoid Adduction","author":"Nishimoto K.","year":"2023","journal-title":"Journal of Voice"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.024455"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.82B1.0820131"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-023-00647-4"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2023.03.017"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.1022"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70220","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70220","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70220","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T12:14:15Z","timestamp":1772972055000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/lary.70220"],"URL":"https:\/\/doi.org\/10.1002\/lary.70220","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]},"assertion":[{"value":"2025-07-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}