Comparative analysis of high-speed videolaryngoscopy images and sound data simultaneously acquired from rigid and flexible laryngoscope: a pilot study.

High-Speed Videoendoscopy (HSV) is becoming a robust tool for the assessment of vocal fold vibration in laboratory investigation and clinical practice. We describe the first successful application of flexible High Speed Videoendoscopy with innovative laser light source conducted in clinical settings. The acquired image and simultaneously recorded audio data are compared to the results obtained by means of a rigid endoscope. We demonstrated that the HSV recordings with fiber-optic laryngoscope have enabled obtaining consistently bright, color images suitable for parametrization of vocal fold oscillation similarly as in the case of the HSV data obtained from a rigid laryngoscope. The comparison of period and amplitude perturbation parameters calculated on the basis of image and audio data acquired from flexible and rigid HSV recording objectively confirm that flexible High-Speed Videoendoscopy is a more suitable method for examination of natural phonation. The HSV-based measures generated from this kymographic analysis are arguably a superior representation of the vocal fold vibrations than the acoustic analysis because their quantification is independent of the vocal tract influences. This experimental study has several implications for further research in the field of HSV application in clinical assessment of glottal pathologies nature and its effect on vocal folds vibrations.

Laryngeal High-Speed Videoendoscopy with Laser Illumination: A Preliminary Report.

<br><b>Introduction:</b> Advances in computer image analysis have enabled the use of new functional imaging methods in the diagnosis of laryngeal diseases. Particularly interesting techniques of dynamic laryngeal imaging involve High Speed Videoendoscopy (HSV). This still-developed technique allows to overcome the limitations of laryngovideostroboscopy (LVS) and a more detailed analysis of the glottal function based on the image of the actual vibrations of the vocal folds. It also enables the determination of objective coefficients parameterizing phonatory vibrations of the vocal folds.</br> <br><b>Aim:</b> The aim of this pilot study was to evaluate the use of a high-speed videoendoscopy set with laser illumination for the diagnosis of glottic pathology in ENT practice.</br> <br><b>Material and methods:</b> The study included 40 patients who underwent LVS followed by HSV. The modern HSV examination kit - Advanced Larynx Imager System (ALIS), used for the first time in a clinical setting in Poland, is characterized by significantly improved, compared to the previously used high-speed cameras, operational parameters - a light head, the possibility of continuous lighting operation without excessive heating of the head tip, registration of the image in full color scale. Thanks to such modernization, the safety and course of the examination do not differ from laryngoscopy conducted with commonly used recorders. The device owes some of these improvements to a laser illuminator which was used for the first time as the main light source in a high-speed camera. In the study, two cases were selected to present the results of HSV and the analysis of the generated kymograms - a woman with no glottic pathology and a man with a polyp of the right vocal fold. In the first case, the HSV examination compared with the LVS revealed a discrete glottis functional disorder in the form of a tendency to hyperphonation. The patient with an organic lesion had a clearly visible irregularity of vocal fold vibrations, which also allowed to trace mucosal wave disturbances related to its reflection from the pathological structure of the glottis and the formation of a return wave, both on the fold affected by the lesion and, to a lesser extent, contralaterally. The glottic dysfunctions observed in the studied patients were confirmed in the generated kymograms and the graphs of the glottal width waveform (GWW), as well as in the parameters calculated on their basis, assessing the frequency and amplitude of phonatory vibrations.</br> <br><b>Conclusions:</b> The use of high-speed videoendoscopy allows for a much more accurate assessment of the phonatory function of the glottis than in laryngovideostroboscopy. The presented HSV system allows for obtaining high quality kinematic images of the larynx, color fidelity, and contrast. The use of this technology in laryngological practice enables precise structural and functional assessment of the glottis and detection of discrete phonation disorders that elude the techniques used so far.</br>.

[THE APPLICATION OF SHORT-TERM EFFICIENCY ANALYSIS IN DIAGNOSING OCCUPATIONAL VOICE DISORDERS]. / ZASTOSOWANIE KRÓTKOOKRESOWEJ ANALIZY WYDOLNOSCIOWEJ W DIAGNOZOWANIU ZABURZEN GLOSU O PODLOZU ZAWODOWYM.

BACKGROUND: An objective determination of the range of vocal efficiency is rather difficult. The aim of the study was to assess the possibility of application of short-term acoustic efficiency analysis in diagnosing occupational voice disorders. MATERIAL AND METHODS: The study covered 98 people (87 women and 11 men) diagnosed with occupational dysphonia throuigh videostroboscopic examination. The control group comprised 100 people (81 women and 19 men) with normal voices. The short-term acoustic analysis was carried out by means of DiagnoScope software, including classical parameters (Jitter group, Shimmer group and the assessment of noise degree NHR), as well as new short-term efficiency parameters determined in a short time period during sustained phonation of the vowel "a." The results were then compared. Results: The values of all the examined classical parameters were considerably higher in the study group of pathological voices than in the control group of normal voices (p = 0.00). The aerodynamic parameter, maximum phonation time, was significantly shorter by over 0.5 s in the study group than in the control group. The majority of the acoustic efficiency parameters were also considerably worse in the study group of subjects with occupational dysphonia than in the control group (p = 0.00). Moreover, the correlation between the efficiency parameters and most of the classical acoustic parameters in the study group implies that for the voices with occupational pathology the decreased efficiency of the vocal apparatus is reflected in the acoustic voice structure. CONCLUSIONS: Effliciency parameters determined during short-term acoustic analysis can be an objective indicator of the decreased phonatory function of the larnx, useful in diagnosing occupational vocal pathology.

[Morphology of the glottis and perceptiv-acoustic characteristic of the voice and speech after extended fronto-lateral epiglotttoplasty]. / Morfologia glosni i charakterystyka percepcyjno-akustyczna glosu i mowy po laryngektomii fronto-lateralnej poszerzonej z nastepowa epiglotoplastyka.

UNLABELLED: For optimalisation glottis morphology and its phonatory function after frontolateral laryngectomy (FLL) the reconstruction of larynx is made; in Clinic of Otolaryngology the most common is using epiglottis wit or without its vertical incision. AIM OF THE STUDY: the influence of widening laryngeal resection and epiglottis incision on shape of reconstructed glottis, level and degree of phonatory closure and perceptive--acoustic characteristic of voice and speech. MATERIAL: 39 patients (38 M and 1 F) after FLL widened of false vocal cord (n = 11), false vocal cord and part of cricoid cartilage (n = 22), whole cricoid cartilage (n = 6). Vertical incision of epiglottis was made in 31 cases. Mean age was 52 (min.-39, max.-70) years. METHODICS: videolaryngoscopic examination, subjective voice estimation using GRBAS scale, objective phonetic--acoustic voice analysis. RESULTS: In videolaryngoscopic examination the most common shape of glottis was irregular triangle (n = 24), rhombus (n = 7), half--moon (n = 2), irregular (n = 6). 2 patients were using whisper. In spectrographic recordings (n = 39) only noise character of stimulation source was in 2 patients, noise--periodic with noise component present in whole acoustic spectrum in 37. F0 for single word and sentence vocalized in affirmative and interrogative form had the value of male voices and its changes during speaking were well noted. In subjective and objective estimation, the worse voice quality was after FLL widened of false vocal cord, part or whole cricoid cartilage. CONCLUSION: 1) FLL with subsequent epiglottoplasty in 94% of patients makes satisfactory morphologic and biophysical conditions for production of voice and sociological efficient speech. 2) Widening resection of false vocal cord, part or whole cricoid cartilage has unbeneficial influence on perceptive--acoustic characteristic of voice and speech.

[Horizontal glottectomy--oncological and functional results. Part II. Morphology of the glottis and perceptive-acoustics characteristic of the voice and speech after horizontal glottectomy]. / Laryngektomia pozioma glosniowa-- wyniki onkologiczne i funkcjonalne. Czesc II. Morfologia glosni i charakterystyka percepcyjno-akustyczna glosu i mowy po laryngektomii poziomej glosniowej.

INTRODUCTION: The authors showed findings concerning glottis morphology and perceptual-acoustic characteristics of voice and speech after partial classical (PCGLg) and extended glottic partial laryngectomy (PEGLg). MATERIAL AND METHODS: 10 patients (9 M., 1 F. average age 56 (min. 47 max. 65) were examined. All patients were undergone glottic partial laryngectomy: a) classical (n = 5) b) extended of vocal process (n = 3) with (n = 2) or without (n = 1) the removal of the mucous false folds, c) extended of part of arytenoid cartilage with (n = 2) or without (n = 1) the removal of the mucous of the false folds. The following examinations were executed: phoniatric, videolaryngoscopic and perceptual-acoustic analysis. RESULTS: After PCGLg and one extended of vocal process, voice and speech has mostly characterized of features of hypofunction dysphonia. Hyperfunction was found in patients after removal of the mucous of the false folds due to leucoplakia. In case of removing of a part of arythenoid cartilage the notable or entire standstill or lack of full phonatory closure were found. The phonetical-acoustic analysis showed that in patients using melodious voice, the character of the source of actuating was periodically-noise, with the component of noise in all range of the course of the acoustic signal of voice. The parameters such as F0, jitter, shimmer does not make coherent conclusions and are less useful in the assessment of the quality of voice. CONCLUSIONS: In case of the resection of the part of the arythenoid cartilage during glottis laryngectomy, we take into account lack of full phonatory closure and using whisper by the patients. Obtaining the reliable conclusions needs continuations of the investigations and increasing number of patients. These researches are in progress.