Zoom in: factors affecting vocal habits during online meetings, a prospective trial on 40 subjects.

PURPOSE: To identify factors that influence vocal habits during online meetings (OMs). METHODS: A prospective trial of forty participants without any known hearing or vocal cord disorders. Subjects participated in an OM divided into six randomly ordered sections, with alterations in audio/speaking equipment and language: the computer's speaker-microphone, a single earbud, two-earbuds or headphones; with/without video, native-language-speaking (Hebrew) versus second language-speaking (English). Each section included free speech, sustained phonation, and a standardized passage. Participants ranked their vocal-effort for each section. Three blinded raters independently scored the voice using the GRBAS scale, and acoustic analyses were performed. RESULTS: No significant difference in self-reported vocal effort was demonstrated between sections. Second-language speaking resulted in significantly increased intensity (p < 0.0001), frequency (p = 0.015), GRBAS (p = 0.008), and strain (p < 0.0001) scores. Using the computer's speaker/microphone resulted in significantly higher strain (p < 0.0001). Using headphones, single or two earbuds resulted in lower intensity and a lower strain score. No differences were detected between OMs with or without video. CONCLUSIONS: Using the computer's microphone/speaker or speaking in a second language during OMs, may result in vocal habits associated with vocal trauma.

Single Stage Transoral Laser Microsurgery for Early Glottic Cancer.

Objectives: The purpose of the study was to present the outcome of our management protocol of a single stage transoral laser microsurgery (SSTLM), with the intention of complete removal of a lesion, considered to be an early glottic cancer. Methods: Between January 2015 to February 2017 patients with the clinical appearance of an early glottic cancer, who were candidates for (SSTLM) management protocol, were included in this study. Type of cordectomy was determined by pre- and intra-operative evaluation of the extent of lesion in cord layers. Results: Thirty patients (6 females, 24 males; mean age 65 years) underwent SSTLM. Twenty-two patients had malignant histopathological diagnosis of severe dysplasia or Cis in 4 patients, microinvasice carcinoma in 3 patients and invasive carcinoma in 15 patients (T1a tumor in 14 and T1b tumor in 1). Eight patients had a nonmalignant histological diagnosis of keratosis without atypia in 2 patients, mild dysplasia in 2 patients and moderate dysplasia in 3 patients. Based on pre- and intra-operative evaluation, 14 subepithelial (type I), 10 subligamental (type II), and 6 transmuscular (type III) cordectomies were performed. Comparison of cordectomies types with postoperative histopathologic diagnosis showed an adequate extent of resection in 26 out of 30 patients (87%). Considering only patients without recent background of direct laryngoscopy and biopsy, an adequate resection was performed in 90% of patients. None of the patients was further treated by external beam radiation. At average follow-up of 21 months, none of the patients developed local recurrence. Conclusion: In selected cases, a SSTLM for clinical appearance of an early glottic cancer, allows a reliable histopathologic diagnosis and a high local control rate with favorable cost effectiveness. A careful pre- and intraoperative evaluation for selecting the appropriate cases for this management is required in order to avoid under- or over-treatment.