Visual assessment of voice disorders in patients with occupational dysphonia
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Department of Clinical Phonoaudiology and Logopedics, Medical University of Białystok, Poland
Department of Rehabilitation, Medical University of Białystok, Poland
Department of Respiratory Diagnostic, Medical University of Białystok, Poland
Corresponding author
Diana Moskal   

Department of Clinical Phonoaudiology and Logopedics, Medical University of Białystok, Poland
Ann Agric Environ Med. 2014;21(4):898-902
In a group of persons using the voice occupationally, the frequent symptoms are hoarseness, voice fatigability and aphonia. Pathological changes in the larynx may have organic or functional character which require different methods of treatment and rehabilitation. Visualization of vibrations of the vocal folds is an essential condition for an appropriate assessment of the causes of dysphonia.

The purpose of the study is assessment of the usefulness of a high-speed imaging (HSI) system in the diagnosis of functional and organic dysphonia of occupational character, compared with digital kymography (DKG) and digital stroboscopy (DS) with a high resolution module.

Material and Methods:
The study group consisted of 64 patients with voice quality disorders with features of occupational dysphonia. The control group consisted of 15 patients with euphonic voice. Analysis of the voice quality parameters during phonation of the ‘e’ vowel was performed using HSI, DKG and stroboscopy of high resolution, by means of a digital HS camera (HRES Endocam, Richard Wolf GmbH, Knittlingen, Germany). Vocal folds vibrations were registered at the rate of 4,000 frames per second.

HSI is the most reliable diagnostic tool giving the possibility of an analysis of the true vibrations of the vocal folds. It also enables an observation of the aperiodicity of vibrations of the vocal folds, while DS with high resolution allows diagnosis of the periodicity of the vibrations.

HSI is particularly useful in the diagnosis of neurologically-based pathology of the voice (paralytic dysphonia) and organic dysphonia. The quickest method of diagnosing the phonatory paresis of the glottis is DKG. The advantage of both HSI and DKG is the non-invasiveness of examinations; however, their limitations are time-consuming and the high cost of equipment.

Bonilha HS, Deliyski DD, Whiteside JP, Gerlach TT. Vocal fold phase asymmetries in patients with voice disorders: a study across visualization techniques. Am J Speech Lang Pathol. 2012; 21(1): 3–15.
Inwald EC, Döllinger M, Schuster M, Eysholdt U, Bohr C. Multiparametric analysis of vocal fold vibrations in healthy and disordered voices in high-speed imaging. J Voice. 2011; 25(5): 576–590.
Kosztyła-Hojna B, Moskal D, Kuryliszyn-Moskal A, Andrzejewska A, Falkowski D. Morphological changes of the vocal fold mucosa in hyperfunctional dysphonia diagnosed by psychoacoustic and videostroboscopic methods. Adv Med Sci. 2011; 56(2): 343–51.
Kosztyła-Hojna B, Andrzejewska A, Moskal D, Rogowski M, Falkowski D, Kasperuk J. Morphological aspects of the euphonic voice. Folia Histochem Cytobiol. 2011; 49(1): 72–79.
Kosztyła-Hojna B, Kuryliszyn-Moskal A, Rogowski M, Moskal D, Dakowicz A, Falkowski D, et al. Wpływ wibracyjnej terapii stymulującej na jakość głosu w postaci hiperfunkcjonalnej dysfonii zawodowej. Otolaryngol Pol. 2012; 66(3): 219–226 (in Polish).
Krausert CR, Olszewski AE, Taylor LN, McMurray JS, Dailey SH, Jiang JJ. Mucosal wave measurement and visualization techniques. J Voice. 2011;25(4): 395–405.
Larsson H, Hertegard S, Lindestad PA, Hammarberg B. Vocal fold vibrations: high-speed imaging, kymography, and acoustic analysis: a preliminary report. Laryngoscope 2000; 110(12): 2117–2122.
Shaw HS, Deliyski DD. Mucosal wave: a normophonic study across visualization techniques. J Voice. 2008; 22(1): 23–33.
Braunschweig T, Schelhorn-Neise P, Dollinger M. Die Untersuchung funktioneller Stimmstörungen mit Hilfe der Hochgeschwindigkeitsvideotechnik. Laryngorhinootologie 2008; 87(5): 323–330 (in German).
Yamauchi A, Imagawa H, Yokonishi H, Nito T, Yamasoba T, Goto T, et al. Evaluation of vocal fold vibration with an assessment form for high-speed digital imaging: comparative study between healthy young and elderly subjects. J Voice. 2012; 26(6): 742–750.
Chodara AM, Krausert CR, Jiang JJ. Kymographic characterization of vibration in human vocal folds with nodules and polyps. Laryngoscope 2012; 122(1): 58–65.
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.
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.
Colton RH, Woo P. Measuring Vocal Fold Function. In: Rubin JS, Sataloff RT, Korovin GS (eds.). Diagnosis and Treatment of Voice Disorders. 3th ed. San Diego, Oxford: Plural Publishing, Inc., 2006. p. 221–247.
Deliyski DD, Hillman RE. State of the art laryngeal imaging: research and clinical implications. Curr Opin Otolaryngol Head Neck Surg. 2010; 18(3): 147–152.
Hertegard S. What have we learned about laryngeal physiology from high-speed digital videoendoscopy? Curr Opin Otolaryngol Head Neck Surg. 2005; 13(3): 152–156.
Svec JG, Schutte HK. Kymographic imaging of laryngeal vibrations. Curr Opin Otolaryngol Head Neck Surg. 2012; 20(6): 458–465.
Schade G, Muller F. Hochgeschwindigkeitsglottographische Diagnostik in der Laryngologie. HNO. 2005; 53(12): 1085–1086, 1088–1091 (in German).
Yan Y, Damrose E, Bless D. Functional analysis of voice using simultaneous high-speed imaging and acoustic recordings. J Voice. 2007; 21(5): 604–616.
Miyaji M, Iwamoto Y, Oda M, Niimi S. Relation between voice quality and pathological vibratory patterns using high-speed digital imaging. Nihon Jibiinkoka Gakkai Kaiho. 1999; 102(3): 354–367 (in Japanese).
Miyaji M. Analysis of pathological vocal fold vibrations using high-speed digital imaging. Nihon Jibiinkoka Gakkai Kaiho. 1998; 101(9): 1099–111 (in Japanese).
Kendall KA. High-speed laryngeal imaging compared with videostroboscopy in healthy subjects. Arch Otolaryngol Head Neck Surg. 2009; 135(3): 274–281.
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