{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:01:04Z","timestamp":1781143264846,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01DC018567"],"award-info":[{"award-number":["R01DC018567"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R56DC020736"],"award-info":[{"award-number":["R56DC020736"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n There are no objective reliable non\u2010invasive screening tools to identify disease severity in patients with idiopathic subglottic stenosis (iSGS), a debilitating and life\u2010threatening disease where scar tissue narrows the airway. This study aims to identify objective voice measures that characterize iSGS disease severity.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Voice recordings of the Rainbow Passage (RP) were obtained in patients with severe iSGS (\n n<\/jats:italic>\n \u2009=\u200910) immediately prior to endoscopic balloon dilation (ED), 2\u2009weeks post\u2010treatment (\n n<\/jats:italic>\n \u2009=\u20096), and in healthy age\u2010matched volunteers (\n n<\/jats:italic>\n \u2009=\u200910). CT neck was obtained before and after ED, and the luminal area was measured relative to cricoid as a percent stenosis. Quantitative voice analysis was performed using VoiceLab, an automated voice analysis program. Unsupervised machine learning was performed using principal component analysis (PCA), and a simple linear regression compared composite voice outcome to luminal airway stenosis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Patients with severe iSGS had increased RP duration (\n p<\/jats:italic>\n \u2009=\u20090.013) and decreased speech rate (\n p<\/jats:italic>\n \u2009=\u20090.012), articulation rate (\n p<\/jats:italic>\n \u2009=\u20090.017), and average syllable duration (\n p<\/jats:italic>\n \u2009=\u20090.0096) compared to healthy controls. Isolated recorded breathing samples during RP in severe iSGS patients showed increased cepstral peak prominence (\n p<\/jats:italic>\n \u2009<\u20090.0001), mean breath count (\n p<\/jats:italic>\n \u2009=\u20090.0039), mean breath duration (\n p<\/jats:italic>\n \u2009<\u20090.0001), and time spent breathing (\n p<\/jats:italic>\n \u2009=\u20090.0002) compared to controls. PCA analysis showed complete separation between normal and severe iSGS, with post\u2010ED iSGS intervening the two groups. Linear regression of the composite principal component 1 strongly correlated with luminal airway caliber.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Objective voice analysis using machine learning provides a novel, non\u2010invasive biomarker which can be used to quantify iSGS disease severity in advance of surgical intervention.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 4.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70459","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:07:26Z","timestamp":1773007646000},"page":"2931-2937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Machine Learning of Acoustic Voice Outcomes in Idiopathic Subglottic Stenosis"],"prefix":"10.1002","volume":"136","author":[{"given":"Ioan A.","family":"Lina","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Colorado Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1004-7606","authenticated-orcid":false,"given":"Raymond J.","family":"So","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9255-7265","authenticated-orcid":false,"given":"Kevin M.","family":"Motz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8471-5449","authenticated-orcid":false,"given":"Alexander T.","family":"Hillel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.25708"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.29783"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24956"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/S13665\u2010022\u201000286\u20106"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818815068"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JVOICE.2021.05.002"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.29325"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/LARY.29760"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489414564249"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","unstructured":"J.Jiang E.Lin andD. 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