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Clinical Trial
. 2012 Feb;21(1):3-15.
doi: 10.1044/1058-0360(2011/09-0086). Epub 2011 Nov 2.

Vocal fold phase asymmetries in patients with voice disorders: a study across visualization techniques

Heather Shaw Bonilha  1 , Dimitar D Deliyski, Joanna Piasecki Whiteside, Terri Treman Gerlach
Affiliations
Clinical Trial

Vocal fold phase asymmetries in patients with voice disorders: a study across visualization techniques

Heather Shaw Bonilha et al. Am J Speech Lang Pathol. 2012 Feb.

Abstract

Purpose: To examine differences in vocal fold vibratory phase asymmetry judged from stroboscopy, high-speed videoendoscopy (HSV), and the HSV-derived playbacks of mucosal wave kymography, digital kymography, and a static medial digital kymography image of persons with hypofunctional and hyperfunctional voice disorders. Differences between the methods of visual judgments and objective measures of left-right phase asymmetry were assessed. The findings were compared with those from a previous study with vocally normal speakers.

Method: Forty-nine persons with voice disorders underwent stroboscopy and HSV. The HSV images were processed, resulting in 4 different spatial or kymographic displays. Two types of phase asymmetries, left-right and anterior-posterior, were visually rated. Objective measures of left-right phase asymmetry were obtained.

Results: From stroboscopy, the HSV playback, and the HSV-derived playbacks, left-right phase symmetry was judged to be symmetrical in 41%, 32%, and 19% of cases, respectively. This difference in playbacks was not seen for anterior-posterior asymmetry. Correlation between visual judgments and objective measures was mild for stroboscopy and moderate to high for all HSV-based playbacks.

Conclusions: The use of kymography appears important for judgments of phase asymmetry. Stroboscopy appears to be sensitive, but possibly not specific, to phase asymmetries. Further development of objective measures is warranted for this feature.

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Figures

Figure 1:
Figure 1:
Posterior, medial, and anterior position frames from a digital kymography (DKG) playback.
Figure 2:
Figure 2:
A medial position frame of a mucosal wave kymography (MKG) playback. Color indicates the phase of glottal edge motion (opening = green, closing = red). See text for more detail.
Figure 3:
Figure 3:
Example of left-right and anterior-posterior phase asymmetry visual-perceptual judgments of DKG playback made via the ALVIN program.
Figure 4:
Figure 4:
Left-right relative asymmetry, A (%), measurement.
Figure 5:
Figure 5:
Objective measures of left-right phase asymmetry for persons with hypofunctional and hyperfunctional voice disorders and vocally-normal speakers producing habitual and pressed phonations.
See this image and copyright information in PMC

References

    1. Bless DM, Hirano M, & Feder RJ (1987). Videostroboscopic evaluation of the larynx. Ear Nose Throat Journal, 66(7), 289–96. - PubMed
    1. Bonilha HS & Deliyski DD (2008). Period and glottal width irregularities in vocally normal speakers. Journal of Voice, 22(6), 699–708. - PubMed
    1. Bonilha HS, Gerlach TT, & Deliyski DD (2008). Phase asymmetries in normophonic speakers: visual judgments and objective findings. American Journal of Speech Language Pathology, 17(4), 367–376. - PMC - PubMed
    1. Deliyski DD (2005). Endoscope motion compensation for laryngeal high-speed videoendoscopy. Journal of Voice, 19(3), 485–496. - PubMed
    1. Deliyski DD, Petrushev PP, Bonilha HS, Gerlach TT, Martin-Harris B, & Hillman RE (2008). Clinical implementation of laryngeal high-speed videoendoscopy: challenges and evolution. Folia Phoniatrica et Logopaedica, 60(1), 33–44. - PubMed

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