{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:39:39Z","timestamp":1792431579026,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the stratified therapeutic effects of semi\u2010occluded vocal tract (SOVT) training based on the degree of vocal fold atrophy and to explore response trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010center prospective cohort study, 180 patients with presbyphonia were stratified into mild, moderate, and severe groups. All participants received standardized SOVT training and were followed for 8\u2009weeks. The primary outcome was change in VHI\u201010. Secondary outcomes included GRBAS, maximum phonation time (MPT), cepstral peak prominence (CPP), acoustic perturbation parameters (jitter, shimmer, PPQ, APQ, and NHR), and glottal gap score. Linear mixed\u2010effects models and latent class growth analysis (LCGA) were applied. Time effects referred to repeated measurements obtained at baseline, Week 4, and Week 8.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant overall improvements were observed in VHI\u201010, MPT, and CPP (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additional acoustic perturbation and noise\u2010related parameters, including jitter, shimmer, PPQ, APQ, and NHR, also improved significantly over time (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A significant time \u00d7 severity interaction was found for VHI\u201010 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with the moderate group demonstrating the greatest improvement. Overall, 68.9% achieved the minimal clinically important difference (MCID) threshold. LCGA identified three response trajectories, with moderate cases more likely to show rapid or sustained improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SOVT training is effective for presbyphonia, with therapeutic response varying according to the severity of vocal fold atrophy. Both cepstral and perturbation\u2010based acoustic analyses supported progressive improvement after intervention. Patients with moderate vocal fold atrophy appeared to derive the greatest therapeutic benefit, suggesting a potential optimal therapeutic window for intervention. Stratified assessment and trajectory\u2010based analysis may facilitate individualized voice rehabilitation strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70597","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:51:04Z","timestamp":1792428664000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stratified Therapeutic Evaluation of Presbyphonia Based on Degree of Vocal Fold Atrophy: Efficacy and Prognostic Differences of Semi\u2010Occluded Vocal Tract Training Across Different Stages"],"prefix":"10.1002","volume":"11","author":[{"given":"Jieyu","family":"Lu","sequence":"first","affiliation":[{"name":"Department of ENT Beijing Haidian Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8967-9170","authenticated-orcid":false,"given":"Wen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of ENT Beijing Haidian Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1007\/s41999-018-0095-6","article-title":"The Aging Voice: A Systematic Review of Presbyphonia","volume":"9","author":"Galluzzi F.","year":"2018","journal-title":"European Geriatric Medicine"},{"issue":"11","key":"e_1_2_10_3_1","first-page":"772","article-title":"Vocal Changes and Laryngeal Modifications in the Elderly (Presbyphonia and Presbylarynx)","volume":"97","author":"Angerstein W.","year":"2018","journal-title":"Laryngologie, Rhinologie, Otologie"},{"issue":"3","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/MOO.0b013e328166794f","article-title":"Presbyphonia: A Review","volume":"15","author":"Kendall K.","year":"2007","journal-title":"Current Opinion in Otolaryngology & Head and Neck Surgery"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"6","article-title":"Presbiphonya","volume":"88","author":"Bruzzi C.","year":"2017","journal-title":"Acta Bio\u2010Medica: Atenei Parmensis"},{"issue":"3","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/j.jvoice.2023.12.010","article-title":"A Systematic Review of Speech\u2010Language Pathology Interventions for Presbyphonia Using the Rehabilitation Treatment Specification System","volume":"40","author":"Saccente\u2010Kennedy B.","year":"2026","journal-title":"Journal of Voice: Official Journal of the Voice Foundation"},{"issue":"2","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jvoice.2014.05.009","article-title":"Semi\u2010Occluded Vocal Tract Exercises: Aerodynamic and Electroglottographic Measurements in Singers","volume":"29","author":"Dargin T. 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