The Laryngoscope (Laryngoscope)

Publisher: American Laryngological, Rhinological, and Otological Society, Wiley

Journal description

For more than 100 years, otolaryngologists, clinicians, and researchers around the world have read The Laryngoscope to keep pace with and learn how to take advantage of the most important advances in the diagnosis and treatment of head and neck disorders. Moreover, the journal is the first choice among otolaryngologists to publish their most important findings and share their own successful techniques with their colleagues.

Current impact factor: 2.14

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 2.144
2013 Impact Factor 2.032
2012 Impact Factor 1.979
2011 Impact Factor 1.752
2010 Impact Factor 2.096
2009 Impact Factor 2.018
2008 Impact Factor 1.877
2007 Impact Factor 1.801
2006 Impact Factor 1.736
2005 Impact Factor 1.617
2004 Impact Factor 1.576
2003 Impact Factor 1.449
2002 Impact Factor 1.384
2001 Impact Factor 1.375
2000 Impact Factor 1.457
1999 Impact Factor 1.266
1998 Impact Factor 1.151
1997 Impact Factor 1.041
1996 Impact Factor 1.118
1995 Impact Factor 0.837
1994 Impact Factor 0.933
1993 Impact Factor 0.915
1992 Impact Factor 1.002

Impact factor over time

Impact factor

Additional details

5-year impact 2.33
Cited half-life 9.40
Immediacy index 0.43
Eigenfactor 0.03
Article influence 0.69
Website Laryngoscope, The website
Other titles Laryngoscope. Supplement (Online), Laryngoscope (Online), The Laryngoscope
ISSN 1531-4995
OCLC 42657561
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo for scientific, technical and medicine titles
    • 2 years embargo for humanities and social science titles
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • On a non-profit server
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is not available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 6 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • If OnlineOpen is not available, AHRC and ESRC authors, may self-archive after 12 months
    • Reviewed 18/03/14
    • Please see former John Wiley & Sons and Blackwell Publishing policies for articles published prior to February 2007
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES/HYPOTHESIS: Children with cleft lip and palate (CLP) often suffer from nasal obstruction that may be related to effects on nasal volume. The objective of this study was to compare side:side volume ratios and nasal volume in patients with unilateral (UCLP) and bilateral (BCLP) clefts with age-matched controls. STUDY DESIGN: Retrospective case-control study using three-dimensional (3D) nasal airway reconstructions. METHODS: We analyzed 20 subjects (age range = 7-12 years) with UCLP and BCLP from a regional craniofacial center who underwent cone beam computed tomography (CT) prior to alveolar grafting. Ten multislice CT images from age-matched controls were also analyzed. Mimics software (Materialise, Plymouth, MI) was used to create 3D reconstructions of the main nasal cavity and compute total and side-specific nasal volumes. Subjects imaged during active nasal cycling phases were excluded. RESULTS: There was no statistically significant difference in affected:unaffected side volume ratios in UCLP (P = .48) or left:right ratios in BCLP (P = .25) when compared to left:right ratios in controls. Mean overall nasal volumes were 9,932 ± 1,807, 7,097 ± 2,596, and 6,715 ± 2,115 mm3 for control, UCLP, and BCLP patients, respectively, with statistically significant volume decreases for both UCLP and BCLP subjects from controls (P < .05). CONCLUSIONS: This is the first study to analyze total nasal volumes in BCLP patients. Overall nasal volume is compromised in UCLP and BCLP by approximately 30%. Additionally, our finding of no major difference in side:side ratios in UCLP and BCLP compared to controls conflicts with pre-existing literature, likely due to exclusion of actively cycling scans and our measurement of the functional nasal cavity. LEVEL OF EVIDENCE: 3b. Laryngoscope, 2015.
    The Laryngoscope 12/2015; DOI:10.1002/lary.25543
  • The Laryngoscope 12/2015;
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    ABSTRACT: Objectives/HypothesisPreoperative localization for parathyroid disease has improved in recent years with the advent of dual-phase 99mTc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) imaging. However, dual-phase imaging is associated with increased cost, time, and radiation dose. The aim of this study was to investigate the need for late-phase imaging when using SPECT/CT for the preoperative localization of parathyroid disease.Study DesignRetrospective chart analysis.MethodsA retrospective review of 75 patients who underwent preoperative imaging localization and subsequent surgical resection for parathyroid disease at a tertiary referral center was performed. Of these, 50 patients met study criteria including preoperative SPECT/CT imaging and specific reporting of early- and late-phase focal radiotracer uptake. Localization accuracy was verified with definitive surgical findings confirmed by histological analysis and evidence of biochemical cure.ResultsAccurate localization of adenoma(s) was seen in 78.0% of patients using dual-phase SPECT/CT. Early-phase imaging alone localized 76.0%, whereas late-phase imaging alone localized 74.0%. Sensitivity and specificity for dual-phase imaging was 84.8% and 89.6%, respectively. In comparison, early-phase localization alone was found to have a sensitivity/specificity of 84.4%/89.4%; sensitivity/specificity of late-phase scanning alone was found to be 80.4%/89.1%. Dual-phase SPECT/CT scanning did not provide a statistically significant improvement in adenoma localization when compared to early-phase scanning alone.Conclusions Although further investigation is needed, the results of this study suggest that early-phase SPECT/CT scanning alone may obviate the need for dual-phase SPECT/CT scanning in the initial preoperative localization workup of parathyroid disease.Level of Evidence4. Laryngoscope, 2015
    The Laryngoscope 11/2015; 125(6). DOI:10.1002/lary.25020
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    ABSTRACT: Objectives/hypothesis: To assess adjuvant therapy in patients undergoing surgical management of oropharyngeal squamous cell carcinoma (OPSCCA) with transoral robotic surgery (TORS) and neck dissection. Study design: A prospective, nonrandomized, consecutive patient series from two separate protocols in a tertiary academic medical center. Methods: Patients undergoing treatment for OPSCCA were selected from a prospective protocol evaluating functional and oncologic outcomes following TORS with a comparator group of OPSCCA patients receiving definitive chemoradiotherapy (CRT) participating in a separate prospective protocol. Results: Forty-two patients represented the TORS group and 38 the CRT group. Twenty (48%) of the TORS patients received surgery only, whereas nine (21%) underwent adjuvant radiotherapy and 13 (31%) adjuvant CRT. Adjuvant therapy patients had a higher overall T (P =.0007) and N (P < .0001) stage than the TORS-only group. Surgery resulted in stage changes in 18 (43%) patients, leading to alteration in therapy for nine (21%) patients. The 3-year overall survival (OS), disease-specific survival (DSS), and locoregional control was 74% versus 90% (P = .30), 94% versus 94% (P = .91), and 72% versus 91% (P = .19) for the TORS-alone versus TORS plus adjuvant therapy groups, respectively. Comparison with the CRT group revealed a survival benefit in the TORS group approaching significance, with a 3-year OS of 83% versus 57% (P = .06) and DSS of 94% versus 85% (P = .08), respectively. Conclusions: Primary surgical management of OPSCCA with TORS and neck dissection provides accurate staging information, which can lead to the appropriate selection of subsequent therapy. This approach does not compromise survival and warrants additional investigation. Level of evidence: 3b. Laryngoscope, 2015.
    The Laryngoscope 10/2015; DOI:10.1002/lary.25534
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    ABSTRACT: Objectives/hypothesis: Observed complications during rigid bronchoscopy, including hypercarbia and hypoxemia, prompted us to assess how well rigid bronchoscopes serve as an airway device. We performed computer-aided design flow analysis of pediatric rigid bronchoscopes to gain insight into flow dynamics. Study design: We made accurate three-dimensional computer models of pediatric rigid bronchoscopes and endotracheal tubes. SOLIDWORKS (Dassault Systemes, Vélizy-Villacoublay, France) flow analysis software was used to analyze fluid dynamics during pressure-controlled and volume-controlled ventilation. Methods: Flow analysis was performed on rigid bronchoscopes and similar outer diameter endotracheal tubes comparing resistance, flow, and turbulence during two ventilation modalities and in common surgical scenarios. Results: Increased turbulent flow was observed in bronchoscopes compared to more laminar flow in endotracheal tubes of similar outer diameter. Flow analysis displayed higher resistances in all pediatric bronchoscope sizes except one (3.0 bronchoscope) compared to similar-sized endotracheal tubes. Loss of adequate ventilation was observed if the bronchoscope was not assembled correctly or if increased peak inspiratory pressures were needed. Anesthesia flow to the patient was reduced by 63% during telescope insertion. Conclusions: Flow analysis illustrates increased turbulent flow and increased airflow resistance in all but one size of pediatric bronchoscopes compared to endotracheal tubes. This increased turbulence and resistance, along with the unanticipated gas distal exit pattern, may contribute to the documented hypercarbia and hypoxemia during procedures. These findings may explain why hypoxemia and hypercarbia are commonly observed during rigid bronchoscopy, especially when positive pressure ventilation is needed. Level of evidence: NA Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25690
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    ABSTRACT: Objectives/hypothesis: To assess the costs, charges, reimbursement, and efficiency of performing awake laryngology procedures in an endoscopy suite (ES) compared with like procedures performed in the operating room (OR). Study design: Retrospective review of billing records. Methods: Cost, charges, and reimbursements for the hospital, surgeon, and anesthesiologist were compared between ES injection laryngoplasty and laser excision procedures and matched case controls in the OR. Time spent in 1) the preoperative unit, 2) the operating or endoscopy suite, and 3) recovery unit were compared between OR and ES procedures. Results: Hospital expenses were significantly less for ES procedures when compared to OR procedures. Reimbursement was similar for ES and OR injection laryngoplasty, though greater for OR laser excisions. Net balance (reimbursement-expenses) was greater for ES procedures. A predictive model of payer costs over a 3-year period showed similar costs for ES and OR laser procedures and reduced costs for ES compared to OR injection laryngoplasty. Times spent preoperatively and the procedure were significantly less for ES procedures. Conclusions: For individual laryngology procedures, the ES reduces time and costs compared to the OR, increasing otolaryngologist and hospital efficiency. This reveals cost and time savings of ES injection laryngoplasty, which occurs at a similar frequency as OR injection laryngoplasty. Given the increased frequency for ES laser procedures, total costs are similar for ES and OR laser excision of papilloma, which usually require repeated procedures. When regulated office space is unavailable, endoscopy rooms represent an alternative setting for unsedated laryngology procedures. Level of evidence: NA Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25653
  • The Laryngoscope 09/2015; DOI:10.1002/lary.25680
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    ABSTRACT: Level of evidence: NA Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25697
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    ABSTRACT: Objectives/hypothesis: Throughout the latter portion of the 19th and early 20th centuries, pneumomassage devices were widely used by otologists to treat a variety of ear diseases. The so-called eardrum massagers produced a regular, repetitive, oscillatory movement through modifying the air pressure in the ear canal. The goal of this study was to trace the invention, clinical use, technological diversification, abandonment, and ultimate resurrection of tympanic pneumomassage. Method: Review of the 19th- and early 20th-century medical journals, texts, and trade catalogs concerning the tympanic pneumomassage. Results: In 1884, the Belgian otologist Charles Delstanche introduced what he called a rarefacteur, and 5 years later he introduced the masseur du tympan. This lead to a frenzied development of imaginative mechanical and electrical pneumassagers with a goal to exercise the tympanic membrane and ossicles to overcome contraction and rigidity. Tympanic pneumomassage rose to prominence in mainstream otology as a treatment for otitis media, chronic deafness, and tinnitus. After gradually fading out of the otological practice by the 1930s, pneumomassage was reintroduced in the 1980s after a half century of obscurity, this time as a novel invention notably for the treatment of Menière's disease. Conclusion: The golden era of pneumomassage illustrates the ingenuity of otologists and medical instrument makers in creating a proliferation of clever devices, as well as how highly touted treatment methods may become widely adopted by practitioners despite the lack of efficacy. It also noteworthy that historic therapeutic methods are sometimes reintroduced for purposes not envisioned by their original makers. Level of evidence: N/A. Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25556
  • The Laryngoscope 09/2015; DOI:10.1002/lary.25647
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    ABSTRACT: Objectives/hypothesis: We aimed to test the hypothesis that chemotherapy changes the gene expression of taste receptors in the tongue to induce dysgeusia in patients with head and neck cancer. Study design: Prospective observation study. Methods: We enrolled 21 patients who received chemoradiotherapy and five patients who underwent radiotherapy for head and neck cancer. The messenger RNA (mRNA) levels of the taste receptor subunits T1R1, T1R2, T1R3, and T2R5 were measured in lingual mucosa scrapings obtained with a small spatula. The perception thresholds of umami, sweet, and bitter tastes were assessed by the whole mouth gustatory test. Results: In four patients with severe stomatitis induced by chemoradiotherapy, the mRNA levels of T1R1, T1R2, T1R3, and T2R5 in the lingual mucosa were significantly decreased. However, in 17 patients with mild/moderate stomatitis, the mRNA levels of T1R3 were significantly and transiently decreased, whereas those of T1R1 and T1R2 remained unchanged and those of T2R5 mRNA were significantly and transiently increased after chemotherapy. There was a significant negative correlation between the perception thresholds of umami or sweet tastes and lingual mRNA levels of T1R3 in patients with mild/moderate stomatitis after chemotherapy. Although the perception threshold of bitter taste remained unchanged, lingual mRNA levels of T2R5 were significantly increased in patients who complained of phantogeusia after chemotherapy. Conclusion: Chemotherapy specifically changed the gene expression of T1R3 and T2R5 in head and neck cancer patients with mild/moderate stomatitis, resulting in both dysgeusia of umami and sweet tastes as well as phantogeusia. Level of evidence: 4. Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25679
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    ABSTRACT: Objectives/HypothesisTo describe changes of motor and nonmotor disabilities in patient with peripheral facial palsy (FP) during treatment using the patient-reported outcome measures (PROMs) Facial Clinimetric Evaluation (FaCE), Facial Disability Index (FDI), and Short Form 36-Item Questionnaire (SF-36) and to analyze predictors for these changesStudy DesignProspective, single-center longitudinal study.Methods One hundred twenty patients with FP underwent at least two PROMs between 2012 and 2015. Predictors for changes of the PROMs were analyzed univariately using Pearson's correlation and multivariately using linear regression models.ResultsThe mean interval between onset of FP to first presentation was 29 ± 64 months and between first and final assessment 8.7 ± 7.2 months. Initial House-Brackmann grading was 4.0 ± 1.3 and final House-Brackmann grading was 2.8 ± 1.6 (P < .001). All mean FaCE and FDI but only some SF-36 subscores improved over time (all P < .05). Adjuvant treatment was an independent predictor for improvement of the FaCE Facial Comfort subscore (P = .015) and a malignant tumor as primary disease for improvement of the FaCE Oral Function subscore (P = .044). Unemployment was a predictor for improvement of the FDI Social/Well-Being Function (P = .035). First assessment <90 days after onset was a predictor for improvement of the SF-36 Bodily Pain subscore (P = .025), a primary malignant disease for improvement of the SF-36 General Health perception (P = .004), and idiopathic FP for improvement of the SF-36 Social Functioning subscore (P = .017).Conclusions Changes of motor function revealed by classical grading systems mostly do not correlate with changes of nonmotor disabilities during treatment of FP. Many other factors are associated with changes of PROMs during the FP treatment.Level of Evidence4. Laryngoscope, 2015
    The Laryngoscope 09/2015; DOI:10.1002/lary.25695
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    ABSTRACT: Objectives/hypothesis: To explore neural connectivity changes associated with repetitive transcranial magnetic stimulation (rTMS) to the temporoparietal junction for patients with bothersome tinnitus. Study design: Randomized, double-blind, controlled clinical trial. Methods: Thirty patients with subjective, nonpulsatile tinnitus for 6 months duration or longer and a score of 36 or greater on the Tinnitus Handicap Inventory completed the study. Participants were randomized to receive either sham or active treatment with rTMS to the temporoparietal junction for either 2 or 4 weeks of therapy. Participants underwent resting state functional connectivity magnetic resonance imaging before therapy and immediately following treatment. Functional connectivity changes between active and sham treatment groups were compared using regions of interest in auditory, default mode, ventral attention, and executive attention networks. Results: Sixteen patients received active rTMS treatment; 14 patients received sham treatment. There were no differences between the active and sham groups in baseline functional connectivity. Neither treatment with rTMS nor sham therapy resulted in statistically significant functional connectivity changes in the examined brain networks. Conclusions: The analysis did not identify any changes in neural connectivity following treatment in patients with bothersome tinnitus. These results are consistent with our findings of lack of symptom changes previously reported in the same group of patients. Measures of neural connectivity may inform future work using rTMS to better understand the possible benefits of neural stimulation for tinnitus. Level of evidence: 1b. Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25650
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    ABSTRACT: Objectives/hypothesis: 1) To determine whether there is a significant relationship between allergic rhinitis and otitis media with effusion (OME), Eustachian tube dysfunction (ETD), or tympanic membrane retraction (TMR) in children in a nationally representative population; and 2) to determine whether age is an effect modifier of any such association because this hypothesis has yet to be tested. Study design: Retrospective analysis of cross-sectional national databases with limited potential for referral bias. Setting and subjects: National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 2005-2010. Methods: Univariate, multivariate, stratified, and subgroup analyses were performed as defined a priori. The primary outcomes were OME, ETD, or TMR; the primary predictor variable was allergic rhinitis, with age evaluated as an effect modifier. Results: Data representing 1,491,045,375 pediatric visits were examined and demonstrated that age was an effect modifier of the assessed association. More specifically, in children 6 years of age or older, the presence of allergic rhinitis significantly increased the odds of OME, ETD, or TMR (odds ratio [OR] 4.20; 95% confidence interval [CI] 2.17, 8.09; P < 0.001), whereas in children less than 6 years of age there was no significant association (OR 1.13; 95% CI 0.53, 2.46; P = 0.745). Conclusion: Age is an effect modifier of the association between allergic rhinitis and OME; a significant relationship is observed in children 6 years of age and older, whereas there is no significant association in younger children. Level of evidence: 2c. Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25682
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    ABSTRACT: Objectives/hypothesis: Oral ulcers are very common and can compromise the quality of life of patients with pain. The objective of this study was to evaluate mucosal healing with curcumin in an animal oral ulcer model. Study design: Experimental study. Methods: Twenty New Zealand white rabbits were used. Round filter paper 6 mm in diameter was soaked with 15 μl 50% acetic acid and applied over the upper labial gingiva, creating a uniform circular ulcer. After creation of an oral ulcer, curcumin, the active substance in tumeric, was applied twice over the ulcer in the experimental group but not in the control group. The ulcer area was calculated by maximal (D) and minimal (d) diameter : π × D × d/4. All animals were weighed, and the area was measured on days 0, 7, and 14. On days 7 and 14, half of the animals were sacrificed and gingival specimens were acquired. Results: Curcumin treatment exhibited accelerated healing such that the gross appearance of the ulcer demonstrated a recognizable difference in wound healing between the curcumin-treated and control groups with time. Weight loss was observed after the creation of oral ulcer in the control group. However, the curcumin-treated group gained weight with time, resulting in a significant weight difference. On day 14, epithelial regeneration was completed in the treated group but incomplete in the control group. Conclusion: Topical application of curcumin enhanced the wound-healing process of oral ulcer in the animal model, which implicate that curcumin can be used as an effective and safe medical tool in the treatment of oral ulcer. Level of evidence: NA. Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25649
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    ABSTRACT: Objectives/hypothesis: Benign midmembranous vocal fold lesions (BMVFLs) are common voice disorders, but interpretation of outcomes following treatment is difficult due to the lack of a standardized nomenclature system for these lesions. Outcome results are increasingly important to third party payers. This study aimed to investigate the outcomes of patients with BMVFLs using a previously validated nomenclature, and to provide incidences and outcome results for each diagnosis. Methods: A retrospective chart review of BMVFL patients was performed. Treatment was individualized but typically involved implementation of nonsurgical therapy followed by phonomicrosurgery as needed. A previously reported BMVFL stratification system was used. Results: A total of 224 patients with BMVFLs were studied. Sixty-seven percent of all patients with a BMVFL underwent phonomicrosurgery. The most common BMVFL types were polyp and nonspecific vocal fold lesion. Pseudocyst represented 0.9% of the cohort. The Voice Handicap Index-10 (VHI-10) and acoustic data demonstrate a high degree of treatment success. The mean change in VHI-10 was greatest for cyst-subepithelial and polyp. Fibrous mass-ligamentous patients had the smallest mean change in VHI-10. Mean post-treatment VHI-10 scores of all the lesions except fibrous mass-ligamentous were within normal limits (<11). Conclusions: This study represents the first outcomes-based report of BMVFLs using a strictly defined nomenclature system for stratification of lesions. Ligamentous fibrous mass lesions have a decreased response to treatment compared to all other lesions. This study demonstrates the ability to return most BMVFL patients to normal speaking voice capabilities following treatment. Level of evidence: 4. Laryngoscope, 2015.
    The Laryngoscope 09/2015; DOI:10.1002/lary.25488
  • The Laryngoscope 09/2015; DOI:10.1002/lary.25665