{"doi":"10.1002/lary.27418","title":"Measurement reliability of phonation threshold pressure in pediatric subjects","abstract":"<jats:sec><jats:title>Objectives/Hypothesis</jats:title><jats:p>Phonation threshold pressure (PTP), the minimum subglottal pressure (P<jats:sub>s</jats:sub>) required for phonation, is sensitive to changes in laryngeal biomechanics and is often elevated with pathology. Little is reported on PTP in children; challenges with task performance and measurement reliability represent barriers to routine clinical assessment.</jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p>Pilot study evaluating PTP and P<jats:sub>s</jats:sub> measurement reliability in children using labial and mechanical interruption.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Twenty‐two subjects aged 4 to 17 years (10.7 ± 3.9 years) participated. Ten trials were performed for each method; task order was randomized. For labial interruption, subjects produced /pα/ five times at softest (onset PTP) and comfortable amplitude. For mechanical interruption, subjects produced a sustained /α/ while a balloon valve interrupted phonation five times for 250 ms each; mechanical interruption was performed with a mouthpiece and mask. PTP was recorded as the difference between P<jats:sub>s</jats:sub> and supraglottal pressure at phonation cessation (offset PTP). Mean PTP and P<jats:sub>s</jats:sub> and intrasubject coefficients of variation were compared. Correlations with age were evaluated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Mean PTP (<jats:italic>P</jats:italic> &lt; .001) and P<jats:sub>s</jats:sub> (<jats:italic>P</jats:italic> = .005) were higher for labial interruption. Intrasubject coefficients of variation for PTP (<jats:italic>P</jats:italic> = .554) and P<jats:sub>s</jats:sub> (<jats:italic>P</jats:italic> = .305) were similar across methods. Coefficient of variation was related to age for mechanical‐mask trials only (<jats:italic>r</jats:italic> = −0.628, <jats:italic>P</jats:italic> = .00175).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Differences in means are likely related to differences in task and PTP hysteresis effect. Reliability is comparable with all methods; using a mouthpiece may be preferable to a mask for mechanical interruption. Measurement of PTP is noninvasive, reliable, and may be a useful adjunct in pediatric voice assessment.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence</jats:title><jats:p>3b</jats:p><jats:p><jats:italic>Laryngoscope</jats:italic>, 129:1520–1526, 2019</jats:p></jats:sec>","journal":"The Laryngoscope","year":2019,"id":684557,"datarank":0.37273599746820013,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"self_citation_contribution":0.37273599746820013,"citation_network_contribution":0.0,"self_endowment_contribution":0.37273599746820013,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1788399,"name":"Austin J. Scholp","orcid":null,"position":1,"is_corresponding":false},{"id":1788400,"name":"Calvin D. Hedberg","orcid":null,"position":2,"is_corresponding":false},{"id":539583,"name":"Jim R. Lamb","orcid":"0000-0002-6133-0586","position":3,"is_corresponding":false},{"id":910409,"name":"Maia N. Braden","orcid":"0000-0002-2661-6060","position":4,"is_corresponding":false},{"id":1788401,"name":"J. Scott McMurray","orcid":null,"position":5,"is_corresponding":false},{"id":521933,"name":"Jack J. Jiang","orcid":"0000-0002-3070-4952","position":6,"is_corresponding":false},{"id":416693,"name":"Matthew R. Hoffman","orcid":"0000-0002-1923-0039","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Measurement reliability of phonation threshold pressure in pediatric subjects","abstract":"<jats:sec><jats:title>Objectives/Hypothesis</jats:title><jats:p>Phonation threshold pressure (PTP), the minimum subglottal pressure (P<jats:sub>s</jats:sub>) required for phonation, is sensitive to changes in laryngeal biomechanics and is often elevated with pathology. Little is reported on PTP in children; challenges with task performance and measurement reliability represent barriers to routine clinical assessment.</jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p>Pilot study evaluating PTP and P<jats:sub>s</jats:sub> measurement reliability in children using labial and mechanical interruption.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Twenty‐two subjects aged 4 to 17 years (10.7 ± 3.9 years) participated. Ten trials were performed for each method; task order was randomized. For labial interruption, subjects produced /pα/ five times at softest (onset PTP) and comfortable amplitude. For mechanical interruption, subjects produced a sustained /α/ while a balloon valve interrupted phonation five times for 250 ms each; mechanical interruption was performed with a mouthpiece and mask. PTP was recorded as the difference between P<jats:sub>s</jats:sub> and supraglottal pressure at phonation cessation (offset PTP). Mean PTP and P<jats:sub>s</jats:sub> and intrasubject coefficients of variation were compared. Correlations with age were evaluated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Mean PTP (<jats:italic>P</jats:italic> &lt; .001) and P<jats:sub>s</jats:sub> (<jats:italic>P</jats:italic> = .005) were higher for labial interruption. Intrasubject coefficients of variation for PTP (<jats:italic>P</jats:italic> = .554) and P<jats:sub>s</jats:sub> (<jats:italic>P</jats:italic> = .305) were similar across methods. Coefficient of variation was related to age for mechanical‐mask trials only (<jats:italic>r</jats:italic> = −0.628, <jats:italic>P</jats:italic> = .00175).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Differences in means are likely related to differences in task and PTP hysteresis effect. Reliability is comparable with all methods; using a mouthpiece may be preferable to a mask for mechanical interruption. Measurement of PTP is noninvasive, reliable, and may be a useful adjunct in pediatric voice assessment.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence</jats:title><jats:p>3b</jats:p><jats:p><jats:italic>Laryngoscope</jats:italic>, 129:1520–1526, 2019</jats:p></jats:sec>","is_dataset_classified":null,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"30408173","pmcid":"PMC6506412","openalex_id":"https://openalex.org/W2900136451","authors":[],"funders":[{"funder_name":"National Institutes of Health, National Institute on Deafness and other Communicative Disorders","grant_id":"R01 DC008153","title":null},{"funder_name":"Diane M. 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