Robert Brinton Fujiki

Indiana University School of Medicine | IUSOM · Otolaryngology–Head & Neck Surgery

Importance Patients with induced laryngeal obstruction (ILO) present with a variety of behavioral health profiles. Identifying these profiles is crucial in that behavioral health conditions may affect treatment duration and outcomes. Objective To characterize the prevalence of anxiety, depression, posttraumatic stress disorder (PTSD), and physical...

Importance Voice disorders impede communication and limit quality of life for many children. However, research demonstrating the prevalence of pediatric voice problems and associated voice use patterns is scarce. This investigation examined the prevalence of voice problems and vocal health characteristics of school-aged children. Objective To exam...

Importance Voice disorders impede communication and detract from quality of life, yet little is known about how voice problems present in adolescents. This study characterized the prevalence of voice problems and vocal health characteristics of adolescents throughout the US. Objective To determine the prevalence of adolescent voice problems in the...

Purpose The purpose of this study was to examine the influence of socioeconomic deprivation on language and developmental outcomes in toddlers with cleft palate with or without cleft lip (CP ± L). Other factors known to influence language outcomes were also considered, including home language history, history of hearing problems, syndromic diagnose...

Children with facial differences, such as repaired cleft lip and palate (CLP), may present with reduced capacity for sensorimotor simulation, particularly in the form of facial mimicry. This study examined whether facial mimicry, emotion recognition, and empathy skills are reduced in children with CLP when compared with sex/age-matched controls. A...

Objective: To examine Spanish terms used for “cleft lip” within the US. Perceived acceptability of these terms was also considered. Design: An online survey was distributed to Spanish-speaking medical interpreters, clinicians, and parents of children with cleft lip. Survey questions probed demographics, language use, preferred term for “cleft lip...

Objective To examine the facial movements children with cleft lip and palate (CLP) employ to express basic emotions. Ability of observers to interpret facial expressions of children with CLP was also considered. Design Prospective case-control design. Setting Outpatient craniofacial anomalies clinic. Patients Twenty-five children with CLP (age 8...

Purpose The purpose of this study was to examine the influence of exercise-induced laryngeal obstruction (EILO) on adolescents. Method Twenty patients (< 17 years) diagnosed with EILO participated in this study. Patients completed semistructured interviews examining their experience with the health care system, treatment, and the effects of EILO s...

Purpose Diagnosing pediatric induced laryngeal obstruction (ILO) requires equipment typically available in specialist settings, and patients often see multiple providers before a diagnosis is determined. This study examined the financial burden associated with the diagnosis and treatment of ILO in pediatric patients with reference to socioeconomic...

Introduction: Sickle Cell Disease (SCD) is an inherited blood disorder with profound implications on a wide variety of tissue types (Kavanagh et al., 2022). As many as 37% of patients with SCD experience silent cerebral infarction by age 14 (DeBaun et al., 2012). Neurological insults can increase risk for voice and swallow disorders which compromis...

Background Behavioral cough suppression therapy (BCST) with a speech–language pathologist is a common treatment for chronic nonspecific cough (a.k.a., tic cough) in children. Yet, the outcomes and duration of pediatric BCST have eluded formal investigation. This study examined whether BCST improves cough in children with nonspecific cough and facto...

Purpose: To compare clinical profiles of pediatric patients with Induced Laryngeal Obstruction (ILO), Exercise Induced Laryngeal Obstruction (EILO), and EILO with non-exertion related secondary triggers (EILO+). Methods: A retrospective observational cohort design was employed. Four-hundred and twenty-three patients <18 years of age were identif...

Purpose This study examined the number of voice therapy sessions and the number of weeks in treatment to achieve desired voice outcomes in adults with voice disorders. Factors that may predict therapy duration were examined, as was the percentage of patients returning to the clinic for additional voice therapy after initial discharge. Method An ob...

Purpose: This study examined treatment outcomes of speech-language pathology intervention addressing exercise-induced laryngeal obstruction (EILO) symptoms in teenage athletes. Method: A prospective cohort design was utilized; teenagers diagnosed with EILO completed questionnaires during initial EILO evaluations, posttherapy, 3-month posttherapy...

Purpose The purpose of this study was to determine whether patient voice-related diagnosis, severity of dysphonia, and rater's experience influence the relationship between laryngeal oscillation ratings made from videostroboscopic and high-speed videoendoscopic (HSV) exams. Method Stroboscopy and HSV exams from 15 patients with adductor spasmodic...

Objective To investigate the relationship between auditory-perceptual ratings of resonance and nasometry scores in children with cleft palate. Factors which may impact this relationship were examined including articulation, intelligibility, dysphonia, sex, and cleft-related diagnosis. Design Retrospective, observational cohort study Setting Outpa...

Purpose This study describes a clinical case of benign bilateral vocal fold lesions in a 4-year-old boy. Acoustic, aerodynamic, auditory-perceptual, and stroboscopic evaluations are described, and the outcomes of intervention are reported. Method Methodology for acoustic, aerodynamic, auditory-perceptual, and stroboscopic data collection and analy...

Purpose Voice therapy is the primary treatment for children presenting with benign morphological vocal fold changes. This study examined the number of voice therapy sessions required to meet treatment goals and identified factors that predicted treatment length for pediatric voice patients. Method An observational cohort design was employed. Data...

To determine the prevalence of laryngeal pathology in children presenting with cleft palate with or without cleft lip (CP ± L) who underwent nasoendoscopy to assess palatal function. A secondary aim was to determine the relationship between patient demographics, resonance, articulation, and prevalence of laryngeal pathology in this population. Ret...

Purpose: This study employed acoustic measures as well as auditory-perceptual assessments to examine the effects of voice therapy in children presenting with benign vocal fold lesions. Methods: A retrospective, observational cohort design was employed. Sustained vowels produced by 129 children diagnosed with benign vocal fold lesions were analyz...

Purpose Vocal exertion is common and often results in reduced respiratory and laryngeal efficiency. It is unknown, however, whether the respiratory kinematic and acoustic adjustments employed during vocal exertion differ between speakers reporting vocal fatigue and those who do not. This study compared respiratory kinematics and acoustic measures i...

Purpose Chronic cough has been shown to be associated with adverse effects on quality of life. There is a paucity of research characterizing quality-of-life factors associated with chronic refractory cough (CRC), a cough persisting > 8 weeks despite evaluation and treatment of possible etiologies. The purpose of this study was to elucidate the feat...

Purpose Paradoxical Vocal Fold Movement (PVFM) may cause airway restriction and resulting dyspnea in the pediatric population and therapy with a speech-language pathologist (SLP) is the primary treatment for children and adolescents diagnosed with Paradoxical Vocal Fold Movement (PVFM). This study examined treatment duration and factors predicting...

Background/Objectives While voice-related therapeutic interventions are often researched preclinically in the porcine model, there are no well-established methods to induce porcine glottic phonation. Described approaches, such as training animals to phonate for positive reinforcement are time-consuming and plagued by inherent variability in the typ...

Background/Objectives Growing reliance on telemedicine has created new triaging challenges. This study investigated how effectively otolaryngology resident auditory-perceptual voice assessments performed via telemedicine determined the need for urgent in-person clinic visits. Methods Twelve otolaryngology resident physicians (PGY1–PGY5) performed...

Objective: This study examined whether speech-language pathologist auditory-perceptual voice assessments can predict the medical urgency of voice disorders. Methods: Twenty speech-language pathologists (SLPs) evaluated 25 voice samples recorded during initial voice evaluations. Voice samples represented a range of dysphonia severity (mild-severe...

Purpose This study aims to investigate the effects of a 10-min vocal exertion task on voice and respiratory measures, to determine whether restorative strategies can mitigate these effects after cessation of exertion, and to assess whether these strategies continue to reduce these detrimental effects when vocal exertion is resumed. Method A prospe...

There is a high prevalence of reported dysphonia symptomology in the fitness instructor population. This is concerning as these reported symptoms of dysphonia, aphonia, and vocal fatigue can significantly compromise quality of life. The purpose of this review is to explore key factors that may contribute to voice problems in the fitness instructor...

Objectives/Hypothesis To investigate the effects of acute vocal exertion on individuals with vocal fatigue and to determine whether semi-occluded vocal tract exercises (SOVTEs) are more effective than vocal rest in mitigating acute effects. Study Design Prospective, repeated-measures design. Methods On consecutive days, 10 individuals (6 males, 4...

Charles, a Master's degree in hand, reports for work in a children's hospital as a member of the outpatient speech‐language pathology team. He is assigned to a team treating voice, swallowing, and upper airway disorders in children, as well as a craniofacial anomalies team. His clients will range from birth to 18 years of age. In this chapter, the...

Objective To determine if auditory-perceptual voice ratings performed using the GRBAS scale correlate with acoustic and aerodynamic measures of voice. A secondary aim was to examine the relationship between GRBAS ratings and patient-reported quality of life scales. Methods GRBAS ratings, acoustic, aerodynamic and patient-reported quality of life r...

Purpose The purpose of this study was to determine concurrent validity of the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) auditory-perceptual scales in children with voice disorders. A secondary purpose was to determine correlation between the GRBAS, CAPE-V, and objectiv...

Purpose Deficiencies in swallowing (aspiration) and in maximum vocal pitch elevation have been shown to correlate in dysphagia. However, the underlying mechanisms that may explain this relationship are not known. In this study, we compare hyoid kinematics between swallowing and maximum vocal pitch elevation in healthy adults. Method Ten young ( M...

Purpose The aim of this study was to compare biomechanical swallowing outcomes and perceived effort as well as detraining effects of the established Head Lift Exercise (HLE) and the novel Recline Exercise (RE) in healthy older adults. Method Twenty-two healthy older adults were randomized to perform either the RE or the HLE for a period of 6 wee...

Purpose The aim of this study was to investigate secondary voice outcomes and detraining effects of 2 head and neck strengthening exercises, which have been used in swallowing rehabilitation, that is, the head-lift exercise (HLE) and the recline exercise (RE), in healthy older adults. Method Twenty-seven healthy older adults (between 60 and 85 yea...

Method: Thirteen healthy subjects (five males and eight females; >65 years) completed a vocal loading challenge. The challenge involved 45 minutes of child-directed speech in the presence of 65 dB multitalker babble background noise. Subjects completed this challenge in both low humidity and moderate humidity in counterbalanced order. Vocal functi...

Vocal loading tasks (VLTs) are used to assess range of function and vulnerability of the laryngeal system. The manner in which VLTs compromise the laryngeal mechanism is multifaceted and only partially understood. This paper presents a scoping review of the literature on VLTs and their effects on the healthy voice. This review paper details the var...

Objectives: Vocal loading tasks provide insight regarding the mechanisms underlying healthy laryngeal function. Determining the manner in which the larynx can most efficiently be loaded is a complex task. The goal of this study was to determine if vocal loading could be achieved in 30 minutes by altering phonatory mode. Owing to the fact that surf...

Objectives: This study examined the effects of a laryngeal desiccation challenge and nebulized isotonic saline on voice production in young, healthy male singers and nonsingers. Study design: This is a prospective, double-blind, within-subjects experimental design. Methods: Participants included 10 male university-trained singers and 10 age-ma...