{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:52:24Z","timestamp":1777877544885,"version":"3.51.4"},"reference-count":54,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Glottal competence and cough effectiveness are associated with aspiration. In unilateral vocal fold paralysis (UVFP), injection laryngoplasty (IL) is the mainstay treatment for those with dysphonia and dysphagia. However, few data exist explaining how IL exerts its effects on aspiration prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effect of IL on voluntary cough strength, glottal closure, and swallowing function. Furthermore, the effects were compared between patients with active treatment\/disease and those without.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Laryngology clinic of single tertiary hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participant<\/jats:title>\n                    <jats:p>Adult patients underwent IL for UVFP between January 2021 and April 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Maximum volitional cough pressure (MCoughP) was quantified before and after IL, as well as clinical voice outcomes and normalized glottal gap area. For those with a complaint of aspiration, the Eating Assessment Tool (EAT-10) questionnaire and Penetration-Aspiration Scale (PAS) were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-one patients were included (26M:15F; age range 32 to 80\u2009years old, mean age 58.7). Clinical voice outcomes and glottal closure were significantly improved in all patients, as well as EAT-10 score (16.22\u2009\u00b1\u200911.83 at pre-IL and 10.83\u2009\u00b1\u200911.17 at post-IL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.008) and PAS [2 (IQR 1.25, 2) at pre-IL and 1 (IQR 1, 2) at post-IL with 20\u2009mL bolus,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.02; 2 (IQR 2, 4) at pre-IL and 2 (IQR 1, 2) at post-IL with cup-sipping,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.007]. Twelve patients had ongoing treatment\/systemic diseases, who had significant improvement in voice and glottal closure but not in PAS. MCoughP was significantly increased in ongoing treatment\/systemic diseases (\u2212) group [42.90\u2009\u00b1\u200920.17\u2009cmH\n                      <jats:sub>2<\/jats:sub>\n                      O at pre-IL, 51.33\u2009\u00b1\u200921.15 at post-IL, 95% CI (\u221216.63, \u22120.23),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.04] but decreased in ongoing treatment\/systemic diseases (+) group [67.98\u2009\u00b1\u200940.06\u2009cmH\n                      <jats:sub>2<\/jats:sub>\n                      O at pre-IL, 55.32\u2009\u00b1\u200931.68 at post-IL, 95% CI (1.37, 23.97),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.03].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>IL significantly improved glottal competence and voice outcomes. However, increased volitional cough pressure and improved swallowing safety were only demonstrated in patients without ongoing treatment or systemic diseases. Patient\u2019s general condition may contribute to the observed effect of IL on dysphagia. Rehabilitation to optimize cough strength and prevent aspiration is beneficial for patients with deteriorating general conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251414088","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T05:56:52Z","timestamp":1769752612000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Injection Laryngoplasty on Cough Strength and Swallowing Safety in Treating Glottal Insufficiency"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0179-4637","authenticated-orcid":false,"given":"Wen-Hsuan","family":"Tseng","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan"},{"name":"Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiang-Ling","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu-Yu","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6521-8631","authenticated-orcid":false,"given":"Tsung-Lin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan"},{"name":"Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan"},{"name":"Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan"},{"name":"Office of Research and Development, National Taiwan University, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00020840-199606000-00004"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/000348940211100803"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28401"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/8917913"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816645765"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/014556131809700707"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29326"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019220"},{"key":"e_1_3_3_10_2","first-page":"569","article-title":"The relative mechanical effectiveness and efficiency of successive voluntary coughs in healthy young adults","volume":"34","author":"Harris RS","year":"1968","unstructured":"Harris RS, Lawson T. 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