Improvement of Vocal Pathologies Diagnosis Using High-Speed Videolaryngoscopy

Abstract

Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution.

Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies.

Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed.

Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology.

Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.

Keywords

stroboscopy - voice disorders - vocal cords - vibration - dysphonia - laryngoscopy

• References

• 1 Hirano M. Structure of the vocal fold in normal and diseased states: anatomical and physical studies. In: Ludlow CL, Hart MC, eds. Proceedings of the Conference on the Assessment of Vocal Pathology (ASHA reports, 11). Rockville, MD: American Speech and Hearing Association; 1981: 11-30
• 2 Woo P. Videostroboscopy and Talbot's Law. In: Woo P, ed. Stroboscopy. San Diego, CA: Plural Publishing Group Inc.; 2010: 11-17
• 3 Hecht S, Verrijp CD. Intermittent stimulation by light: IV. A theoretical interpretation of the quantitative data of flicker. J Gen Physiol 1933; 17 (2) 269-282
• 4 Harley B. Optical Toys. 1st ed. Princes Risborough, Buckinghamshire, UK: Shire Publications; 1989
• 5 Hirano M, Bless DM. Introduction and historical review. In: Hirano M, Bless DM, eds. Videostroboscopic Examination of the Larynx. San Diego, CA: Singular Publishing Group Inc.; 1993: 1-20
• 6 Wendler J. Stroboscopy. J Voice 1992; 6 (2) 149-154
• 7 Kendall KA. High-speed laryngeal imaging compared with videostroboscopy in healthy subjects. Arch Otolaryngol Head Neck Surg 2009; 135 (3) 274-281
• 8 Kendall KA. High-speed digital imaging of the larynx: recent advances. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (6) 466-471
• 9 Woo P. Quantification of videostrobolaryngoscopic findings—measurements of the normal glottal cycle. Laryngoscope 1996; 106 (3 Pt 2) (Suppl. 79) 1-27
• 10 Woo P, Colton R, Casper J, Brewer D. Diagnostic value of stroboscopic examination in hoarse patients. J Voice 1991; 5 (3) 231-238
• 11 Sataloff RT, Spiegel JR, Caroll LM, Schiebel BR, Darby KS, Rulnick R. Strobovideolaryngoscopy in professional voice users: results and clinical value. J Voice 1988; 1 (4) 359-364
• 12 Hertegård S, Larsson H, Wittenberg T. High-speed imaging: applications and development. Logoped Phoniatr Vocol 2003; 28 (3) 133-139
• 13 Patel RR, Liu L, Galatsanos N, Bless DM. Differential vibratory characteristics of adductor spasmodic dysphonia and muscle tension dysphonia on high-speed digital imaging. Ann Otol Rhinol Laryngol 2011; 120 (1) 21-32
• 14 Bonilha HS, Deliyski DD. Period and glottal width irregularities in vocally normal speakers. J Voice 2008; 22 (6) 699-708
• 15 Braunschweig T, Flaschka J, Schelhorn-Neise P, Döllinger M. High-speed video analysis of the phonation onset, with an application to the diagnosis of functional dysphonias. Med Eng Phys 2008; 30 (1) 59-66
• 16 Yan Y, Ahmad K, Kunduk M, Bless D. Analysis of vocal-fold vibrations from high-speed laryngeal images using a Hilbert transform-based methodology. J Voice 2005; 19 (2) 161-175
• 17 Hsiung MW. Videolaryngostroboscopic observation of mucus layer during vocal cord vibration in patients with vocal nodules before and after surgery. Acta Otolaryngol 2004; 124 (2) 186-191
• 18 Chodara AM, Krausert CR, Jiang JJ. Kymographic characterization of vibration in human vocal folds with nodules and polyps. Laryngoscope 2012; 122 (1) 58-65
• 19 Harries ML, Morrison M. The role of stroboscopy in the management of a patient with a unilateral vocal fold paralysis. J Laryngol Otol 1996; 110 (2) 141-143
• 20 Colton RH, Woo P, Brewer DW, Griffin B, Casper J. Stroboscopic signs associated with benign lesions of the vocal folds. J Voice 1995; 9 (3) 312-325
• 21 Bonilha HS, Deliyski DD, Gerlach TT. Phase asymmetries in normophonic speakers: visual judgments and objective findings. Am J Speech Lang Pathol 2008; 17 (4) 367-376
• 22 Olthoff A, Woywod C, Kruse E. Stroboscopy versus high-speed glottography: a comparative study. Laryngoscope 2007; 117 (6) 1123-1126
• 23 Patel R, Dailey S, Bless D. Comparison of high-speed digital imaging with stroboscopy for laryngeal imaging of glottal disorders. Ann Otol Rhinol Laryngol 2008; 117 (6) 413-424
• 24 Larsson H, Hertegård S, Lindestad PA, Hammarberg B. Vocal fold vibrations: high-speed imaging, kymography, and acoustic analysis: a preliminary report. Laryngoscope 2000; 110 (12) 2117-2122
• 25 Yamauchi A, Imagawa H, Sakakibara K , et al. Phase difference of vocally healthy subjects in high-speed digital imaging analyzed with laryngotopography. J Voice 2013; 27 (1) 39-45
• 26 Pinheiro AP, Montagnoli AN, Dajer ME, Tsuji DH, Hachiya A, Gomes DS. Estimação dos padrões de vibração cordal das pregas vocais utilizando videolaringoscopia de alta velocidade. XXIII Congresso Brasileiro em Engenharia Biomédica; Porto de Galinhas - PE. 1 a 5 de outubro de 2012
• 27 Pimenta RA, Dajer ME, Hachiya A, Cordeiro GF, Tsuji DH, Montagnoli AN. High-speed kymography indentifies the immediate effects of voiced vibration in healthy vocal folds. Int Arch Otol. 2013; 17 (1) 80-84