{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T02:08:54Z","timestamp":1783908534421,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze the correlation between vocal tract fat volume and patient tolerance to office\u2010based laryngeal surgery using the transnasal approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The medical records and video recordings of all patients who underwent office\u2010based laryngeal surgery (OBLS) between April 2024 and January 2026 were reviewed. Demographic data included age, gender, body mass index (BMI), history of smoking, history of reflux disease, allergy, voice diagnosis, and type of OBLS. Three fat compartments were analyzed: (1) parapharyngeal fat volume at the palatal level, (2) parapharyngeal fat at the glossal level, and (3) the pre\u2010epiglottic adipose tissue. Patient tolerance was evaluated using the IOWA Satisfaction with Anesthesia Scale and a Visual Analog Scale (VAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty patients were included in the study. The mean IOWA score of the total group was 2.55\u2009\u00b1\u20090.68, and the mean VAS tolerance score was 8.70\u2009\u00b1\u20091.65. Linear regression analysis accounting for potential confounding factors showed a moderate, negative, statistically significant correlation between the volume of parapharyngeal fat at the level of the palate and IOWA scale score (adjusted coefficient\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.567,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049). There was also a mild, negative, non\u2010significant correlation between the volume of parapharyngeal fat at the level of the palate and VAS scores (adjusted coefficient\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.251,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.211).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An increase in parapharyngeal fat volume at the level of the palate was associated with a decrease in IOWA scale score, suggesting reduced tolerance to OBLS. A study with a larger sample size is needed to draw stronger conclusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70547","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T06:46:13Z","timestamp":1776062773000},"page":"3534-3540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vocal Tract Fat Distribution and Patient Tolerance to Transnasal Office\u2010Based Laryngeal Surgery"],"prefix":"10.1002","volume":"136","author":[{"given":"Anthony","family":"Nasr","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roula","family":"Hourani","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana","family":"Ghzayel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghena","family":"Lababidi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deena","family":"Achkar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine American University of Beirut  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Sarkis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2827-1289","authenticated-orcid":false,"given":"Patrick","family":"Abou Raji Feghali","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Ghadieh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majd","family":"Al Irani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beirut Arab University  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1493-3568","authenticated-orcid":false,"given":"Abdul\u2010Latif","family":"Hamdan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery American University of Beirut Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Office\u2010Based Laryngeal Surgery","author":"Hamdan A. L.","year":"2019"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-35283-6"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814541627a151"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215122001566"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2018.01.011"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2011.10.003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25653"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25007"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818764412"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.02.041"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2022.12.003"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2023.03.003"},{"key":"e_1_2_11_14_1","article-title":"Surgical and Voice Outcomes of Office\u2010Based Laser Therapy for Benign Lesions of the Vocal Folds: A Systematic Review of the Literature","author":"Miri M.","journal-title":"Journal of Voice"},{"key":"e_1_2_11_15_1","first-page":"282","article-title":"Surgical and Voice Outcomes of Office\u2010Based Vocal Fold Dysplasia and Leukoplakia Surgery: A Systematic Review","volume":"37","author":"Miri M.","year":"2025","journal-title":"Journal of Voice"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.11.026"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000231455.19183.8c"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23551"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25930"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3282f1a92c"},{"key":"e_1_2_11_21_1","first-page":"101","volume-title":"Office\u2010Based Laryngeal Surgery","author":"Hamdan A. L.","year":"2019"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3281574582"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2015.08.022"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.12.009"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.1091"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29370"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.70256"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22185"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.01.019"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.70064"},{"key":"e_1_2_11_31_1","article-title":"Impact of Upper Airway Narrowing on Patient Tolerance in Office\u2010Based Blue Laser Surgery","author":"Hamdan A. L.","journal-title":"Journal of Voice"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.70180"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25758"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2008.03.024"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10230"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.00929"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1772827"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-020-0631-6"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3181782706"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-53515-5"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2012.62.3.297"},{"key":"e_1_2_11_42_1","article-title":"Correlation Between Obesity and Patient Tolerance to Office\u2010Based Trans\u2010Nasal Laryngeal Procedures","author":"Hamdan A. L.","journal-title":"Journal of Voice"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202410-1027OC"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsab158"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70547","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70547","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70547","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:47:21Z","timestamp":1783907241000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70547"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,12]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/lary.70547"],"URL":"https:\/\/doi.org\/10.1002\/lary.70547","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,12]]},"assertion":[{"value":"2026-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}