Abstract
Although many quantitative parameters have been devised to describe abnormalities in vocal fold vibration, little is known about the priority of these parameters. We conducted a prospective study using high-speed digital imaging to elucidate disease-specific key parameters (KPs) to characterize the vocal fold vibrations of individual voice disorders. From 304 patients with various voice disorders and 46 normal speakers, high-speed digital imaging of a sustained phonation at a comfortable pitch and loudness was recorded and parameters from visual-perceptual rating, laryngotopography, digital kymography, and glottal area waveform were calculated. Multivariate analysis was then applied to these parameters to elucidate the KPs to explain each voice disorder in comparison to normal subjects. Four key parameters were statistically significant for all laryngeal diseases. However, the coefficient of determination (R2) was very low (0.29). Vocal fold paralysis (8 KPs, R2 = 0.76), sulcus vocalis (4 KPs, R2 = 0.74), vocal fold scarring (1 KP, R2 = 0.68), vocal fold atrophy (6 KPs, R2 = 0.53), and laryngeal cancer (1 KP, R2 = 0.52) showed moderate-to-high R2 values. The results identified different KPs for each voice disorder; thus, disease-specific analysis is a reasonable approach.
Highlights
A person’s voice results from the interaction and matching of respiration, vocal fold vibrations, and speech movements
high-speed digital imaging (HSDI) will be the gold standard for vocal fold vibratory assessment because of its potential for multifaceted, objective, and quantitative analyses
HSDI is not yet widely used in clinical practice due to unsolved disadvantages: the relative scarcity of studies to prove the merits of HSDI and its superiority to VS, high cost, time consumed during data processing and analysis, and the lack of standardized techniques and parameters
Summary
A person’s voice results from the interaction and matching of respiration, vocal fold vibrations, and speech movements. VS is limited to specific patient populations because it is inapplicable to non-sustained phonations or moderate-to-severe dysphonia [2,3]. Another common imaging approach is high-speed digital imaging (HSDI). HSDI registers actual vocal fold vibrations with a high sampling rate (2000–10,000 Hz). It provides rich temporal information and permits reliable quantitative analysis. Because of its potential in multifaceted, objective, and quantitative analysis, HSDI is considered to be the future gold standard for vocal fold vibratory assessment
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