Vocal Fold Vibration in Vocal Fold Atrophy: Quantitative Analysis With High-Speed Digital Imaging

Abstract

Vocal fold vibrations of vocal fold atrophy (VFA), a rapidly increasing voice disorder owing to worldwide societal aging, have not been clarified by high-speed digital imaging (HSDI). The HSDI method was performed on 46 patients (33 males and 13 females) with VFA and 20 vocally healthy subjects (8 males and 12 females), and the obtained data were quantitatively evaluated by frame-by-frame analysis, laryngotopography, single- and multi-line kymography, and glottal area waveform. Overall, patients with VFA revealed larger open quotients, larger lateral phase difference, larger integral glottal width (the average glottal width over a glottal cycle), and smaller speed index than vocally healthy subjects. Some gender difference was noted: in males, lateral phase difference was not significant; and in females, integral glottal width and speed index were not significant. Correlation study revealed moderate correlations between HSDI-derived parameters and conventional acoustic or aerodynamic parameters. The combination of multiple HSDI analysis methods was effective in documenting the characteristics of vocal fold vibrations in VFA. The knowledge of general vibratory characteristics and gender difference is beneficial for the appropriate clinical care of VFA.