{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:26:25Z","timestamp":1786969585307,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Frailty is associated with high mortality and morbidity, even for low\u2010risk procedures. The role of frailty in postoperative quality of life is not well characterized. We studied the relationship between frailty and voice outcomes after type 1 thyroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective chart review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic tertiary care voice center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected for type 1 thyroplasties performed 2017 to 2024. Voice was evaluated preoperatively and postoperatively with perceptual voice measures (grade, roughness, breathiness, asthenia, and strain [GRBAS]) and Voice Handicap Index\u201010 (VHI\u201010). Frailty was measured using the Modified Frailty Index\u20105 (MFI\u20105). Data were compared using analysis of variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 127 patients underwent surgery (59 female, 47%); 79 were for vocal fold motion impairment (62.2%) and 48 atrophy (37.8%). Mean age was 61.0 (95% confidence interval [CI] 58.5\u201064.5). In total, 39 had an MFI\u20105 score of 0 (\u201crobust,\u201d 30.7%), 48 MFI\u20105\u2009=\u20091 (\u201cpre\u2010frail,\u201d 37.8%), and 40 MFI\u20105\u2009=\u20092 or more (\u201cfrail,\u201d 31.4%). Preoperative voice measures were similar across cohorts except for breathiness, which was greater among frail patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0245). Improvements in perceptual voice outcomes were seen in all groups. The improvement in breathiness was greater among frail patients (\u22121.4, 95% CI \u22121.0 to \u22121.8) compared to pre\u2010frail (\u22120.8, \u22120.5 to \u22121.1) and robust (\u22120.7, \u22120.2 to \u22121.1,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.0203). Forty\u2010eight patients had preop and postop VHI\u201010 data. Patients had similar improvement in VHI\u201010 across levels of frailty (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.5954).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Improvements in voice after type 1 thyroplasty were similar across levels of frailty. This was true for both atrophy and unilateral vocal fold immobility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70395","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:45:47Z","timestamp":1786967147000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frailty Severity and Voice Outcomes After Type 1 Thyroplasty"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1373-7338","authenticated-orcid":false,"given":"Ari D.","family":"Schuman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex H.","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Abarca","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Brungardt","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julina","family":"Ongkasuwan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam R.","family":"Szymanowski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas 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