High speed digital videolaringoscopy: evaluation of vocal nodules and cysts in women

Digital Videokymography: Analysis of Glottal Closure in Adults

INTRODUCTION

High-speed videolaryngoscopy and quantitative analysis of laryngeal images are relevant in accurately diagnosing vocal fold closure patterns.

OBJECTIVE

To analyze the parameters of digital videokymography obtained through high-speed videolaryngoscopy in women and men with complete and incomplete glottal closure, and posterior glottal chink.

METHODS

We conducted an observational, analytical, cross-sectional study with data from 65 adults, which we divided into groups according to sex and glottal closure. Digital videokymography parameters were analyzed using an image-processing program. The Anderson-Darling and Mann-Whitney U tests were used to verify sample normality and compare videokymography parameters between groups, respectively. The significance level was set at 5%.

RESULTS

Among 65 laryngeal images, 20 each were from women with complete and incomplete glottal closure, and 20 and 5 were from men with complete and incomplete glottal closure, respectively. Considering the clinical relevance of the evaluated data, groups of 11 women and 4 men with posterior glottal chink were compared with sex-similar groups with complete glottal closure. Digital videokymography showed a lower maximum and mean vocal fold opening in women with incomplete glottal closure, and a lower dominant left vocal fold-opening amplitude and higher dominant frequency of bilateral vocal fold opening in men with incomplete glottal closure. It also showed a lower closed phase percentage in the posterior region for women and men, with higher closed phase percentage in the anterior and middle regions in women. Both groups with posterior glottal chink showed similar results.

CONCLUSION

Incomplete glottal closure may interfere with the results of the digital videokymography parameters, with higher impact on the posterior vocal fold region in males and the middle and anterior vocal fold regions in females.

Visual-perceptive assessment of glottic characteristics of vocal nodules by means of high-speed videoendoscopy

OBJECTIVE

Visual-perceptive assessment of glottic characteristics of vocal nodules by means of high-speed videoendoscopy.

METHODS

Descriptive observational research with convenience sampling of five laryngeal videos of women with an average age of 25 years. The diagnosis of vocal nodules was defined by two otolaryngologists, with 100% intra-rater agreement and 53.40% inter-rater agreement and five otolaryngologists as judge assessed the laryngeal videos based on an adapted protocol. The statistical analysis calculated measures of central tendency and dispersion, as well as percentage. The AC1 coefficient was used for agreement analysis.

RESULTS

In high-speed videoendoscopy imaging, vocal nodules are characterized by amplitude of the mucosal wave and muco-undulatory movement with magnitude between 50% and 60%. Non-vibrating segments of vocal folds are scarce, and the glottal cycle does not show a predominant phase, it is symmetric and periodic. Glottal closure is characterized by the presence of a mid-posterior triangular chink (double chink or isolated mid-posterior triangular chink), without movement of supraglottic laryngeal structures, with irregular contour of the free edge of vocal folds, which are vertically on-plane.

CONCLUSION

Vocal nodules present mid-posterior triangular chink and irregular free edge contour. Amplitude and mucosal wave were partially reduced.

LEVEL OF EVIDENCE

Level 4 (Case-series).