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Objective: Benign phonotraumatic lesions of the vocal folds (BVFLs) are typically seen in younger female patients with high vocal loads. Hemorrhagic polyps (HPs) do not fit the classic paradigm of most BVFLs, as they tend to occur in an older population, have a male predominance, and report to result from a vocal accident. We present one of the largest cohorts of HPs, to reexamine their etiology and clinical features. Methods: Retrospective cohort study, inclusive of all patients with HP managed by the senior authors between the years 2016 through 2023. Demographic data, management, phonotraumatic risk factors, pre‐ and post‐treatment VHI‐10 were reviewed. We examined patient videostroboscopy, categorized the size of the lesion, and identified any concurrent mucosal abnormality. Results: One hundred and eleven patients had confirmed HP, 84 males (75.7%). Thirty‐five patients were size category 1; pinpoint (28.9%), 57 were category 2; less than 1/3rd the vocal fold (45.5%), and 26 were category 3; greater than 1/3rd the vocal fold (21.5%). Ten patients (9%) had bilateral HPs. Thirty‐five patients had an additional 40 mucosal lesions in addition to the HP(s). The onset of symptoms was gradual in 60% of patients. The mean pretreatment VHI‐10 was 18.0 (SD 10.7), compared to 6.0 (SD 10.5) post‐treatment, (p <.001). 57/111 patients reported high voice demand professions or recreational activities. The average self‐reported talkative scale score was 7.6/10. Patients were managed with operative microdirect laryngoscopy and microflap excision (53.1%), in‐office clinic potassium titanyl phosphate (KTP) laser (24.3%), voice therapy alone (7.2%), and KTP in the operating room (6.3%). Conclusions: In our cohort, most patients were male, had high vocal demands, reported gradual symptom onset, and almost a third of patients had additional BVFLs. Level of evidence: Level 3: Retrospective cohort study. [ABSTRACT FROM AUTHOR]

Naphthenic Acids (NAs) are widely believed to universally act in a stabilizing capacity during the formation of water-in-crude oil emulsions. This work provides evidence to the contrary wherein differences between commercially acquired NAs and those extracted from crude exhibit opposing effects on emulsion stability. Addition of the commercial NAs to a crude oil prior to water-in-oil emulsion formation resulted in an increase in emulsion destabilization rate. This was demonstrated via quantification of water droplet coalescence using pulsed field gradient nuclear magnetic resonance (NMR) and, over long timescales in the visual observation of the disengagement of a free water phase. The efficacy of the commercial NAs to act in such a demulsification capacity was shown to be effective at concentrations as low as 0.5v/v% and in the presence of saline water of up to 3.5 wt% NaCl. Differences in NA demulsifying ability was observed between three crude oils of various origins with some demonstrating clear visual phase separation whilst others remained in an emulsified state. Conversely, addition of NAs extracted from a crude oil at similar concentrations had negligible effect on the rate of emulsion destabilization. Comparative characterization of the commercial and indigenous NAs was performed using 1H NMR, Diffusion Ordered Spectroscopy (DOSY), Rheometry, Pendant Drop Tensiometry, and Gas Chromatography–Mass Spectrometry. The results of this characterization indicated that differences in emulsion stability were governed not by differences in the reduction of emulsion droplet interfacial tension (IFT) but by the kinetics of molecular diffusion of the NAs during both the emulsification and destabilization phases. [ABSTRACT FROM AUTHOR]

This study analyses the complex emotions and level of user engagement associated with mentions of Russia by Lithuanian socio-political influencers on publicly available Facebook posts between 2015 and 2020. Using the CrowdTangle API and a mixed methods approach to data, we examined four potentially sensitive periods – around elections, a political corruption scandal, and during the first COVID-19-related national lockdowns, annotated for emotion and topic content and analyzed with quantitative modeling of emotion data coupled with qualitative analysis of posts in order to contextualize results. Curiously, we found no heightened negativity expressed toward Russia around election time. We identified, however, considerable anger and contempt beneath the overall veneer of happiness in our sampled posts, with posts mentioning Russia generally containing more negative emotions. [ABSTRACT FROM AUTHOR]

Objective: Vocal fold scar and sulcus pose significant treatment challenges with no current optimal treatment. Platelet‐rich plasma (PRP), an autologous concentration of growth factors, holds promise for regenerating the superficial lamina propria. This study aims to evaluate the potential benefits of serial PRP injections on mucosal wave restoration and vocal function. Methods: In a prospective clinical trial across two institutions, patients with vocal fold scar underwent four serial PRP injections, one month apart. Blinded independent laryngologists and expert listeners used pretreatment and one‐month post‐fourth injection videostroboscopy and CAPE‐V assessments to evaluate mucosal wave and voice quality changes, respectively. Additionally, patient reported outcome measures (PROMs) were evaluated. Results: In the study, 15 patients received 55 PRP injections without adverse effects. Eight patients (53.3%) had mild, three patients (20%) had moderate, and four patients (26.7%) had severe scar. There was an average reduction of 8.7 points in post‐treatment VHI‐10 scores (p = 0.007). The raters observed an improvement in post‐treatment voice in 73.4% of cases, and CAPE‐V scores showed a reduction of 18.8 points on average (p = 0.036). The videostroboscopic VALI ratings showed an improvement in mucosal wave rating from 2.0 to 4.0. On average, the raters perceived the post‐PRP exams to be better in 56.7% of cases. Conclusions: PRP has been validated as a safe autologous option for treatment of vocal fold scar. While results for mucosal wave and voice quality varied, there was a consistent improvement in PROMs. Level of Evidence: 3: Prospective cohort study, with blinded analysis Laryngoscope, 134:5021–5027, 2024 [ABSTRACT FROM AUTHOR]

Objective: Safe home tracheostomy care requires engagement and troubleshooting by patients, who may turn to online, AI‐generated information sources. This study assessed the quality of ChatGPT responses to such queries. Methods: In this cross‐sectional study, ChatGPT was prompted with 10 hypothetical tracheostomy care questions in three domains (complication management, self‐care advice, and lifestyle adjustment). Responses were graded by four otolaryngologists for appropriateness, accuracy, and overall score. The readability of responses was evaluated using the Flesch Reading Ease (FRE) and Flesch–Kincaid Reading Grade Level (FKRGL). Descriptive statistics and ANOVA testing were performed with statistical significance set to p <.05. Results: On a scale of 1–5, with 5 representing the greatest appropriateness or overall score and a 4‐point scale with 4 representing the highest accuracy, the responses exhibited moderately high appropriateness (mean = 4.10, SD = 0.90), high accuracy (mean = 3.55, SD = 0.50), and moderately high overall scores (mean = 4.02, SD = 0.86). Scoring between response categories (self‐care recommendations, complication recommendations, lifestyle adjustments, and special device considerations) revealed no significant scoring differences. Suboptimal responses lacked nuance and contained incorrect information and recommendations. Readability indicated college and advanced levels for FRE (Mean = 39.5, SD = 7.17) and FKRGL (Mean = 13.1, SD = 1.47), higher than the sixth‐grade level recommended for patient‐targeted resources by the NIH. Conclusion: While ChatGPT‐generated tracheostomy care responses may exhibit acceptable appropriateness, incomplete or misleading information may have dire clinical consequences. Further, inappropriately high reading levels may limit patient comprehension and accessibility. At this point in its technological infancy, AI‐generated information should not be solely relied upon as a direct patient care resource. [ABSTRACT FROM AUTHOR]

Objective: Vocal fold injection medialization (VFIM) is widely used as an initial treatment for unilateral vocal fold paralysis (UVFP). Current practices employ materials that share the limitation of temporary clinical effect from variable resorption rates. A novel silk protein microparticle‐hyaluronic acid‐based material (silk‐HA) has demonstrated cellular infiltration and tissue deposition that may portend a durable medialization effect. We report on ≥12 months outcomes after VFIM with silk‐HA. Methods: Prospective open‐label study of patients with UVFP that elected treatment with VFIM with silk‐HA. Blinded experts rated laryngeal stroboscopic exams. Results: Seventeen patients with UVFP underwent VFIM with silk‐HA. Twelve of the 17 patients have ≥12 months follow‐up. Seven patients demonstrated durable treatment benefit ≥12 months after injection with median improvement of 19 (p = 0.0156) in VHI‐10. There was no significant change in VHI‐10 between 1 and 12 months for these patients. Blinded ratings indicated that 5/7 patients with sustained improvements in VHI‐10 exhibited complete or touch glottal closure at 12 months. Two of the seven patients exhibited a small (<1 mm) glottal gap at 12 months. Seven patients experienced initial benefit with later regression 3–4 months after injection. Conclusion: VFIM with silk‐HA can offer durable improvement in voice‐related outcomes for UVFP past 12 months. A subset of patients treated with silk‐HA experienced early loss of effect around 3–4 months postinjection. Clinical factors predictive of sustained treatment response to silk‐HA injection require further exploration. Level of Evidence: 3 Laryngoscope, 134:3679–3685, 2024 [ABSTRACT FROM AUTHOR]