Summary
Objective
Although high-speed imaging (HSI) has been identified as a valuable tool in phonatory
biomechanics research, to date, there have only been a selected number of reports
investigating the clinical utility of HSI. We aim to elucidate the role of HSI in
the diagnosis of the dysphonic patient.
Methods
The video files from 28 consecutive dysphonic patients with concurrently acquired
videostroboscopy and HSI were retrospectively collected. Stroboscopy video files were
edited to include vibratory motion only. Videos were then anonymously and randomly
presented to four academic laryngologists. Experts were asked to assign a single best
diagnosis for each video file. Assigned diagnoses were then compared with treatment
diagnoses conferred based on medical history, phonatory evaluation, laryngeal examination,
and response to treatment.
Results
Interrater analysis for the four laryngologists demonstrated significant and meaningful
correlations for the diagnoses of polyps, cysts, nodules, and normal examination using
stroboscopy (kappa>0.40, P<0.001). The experts demonstrated significant and meaningful correlations for the diagnoses
of polyps, presbyphonia, and normal examination using HSI (kappa>0.40, P<0.001). Combined intrarater analysis performed by comparing single rater's diagnosis
for single patient across both modalities resulted in poor correlation without statistical
significance (kappa = 0.30, P=0.07). Both stroboscopy- and HSI-assigned diagnoses matched the treatment diagnoses
at equal predicted frequencies (32.3%), as demonstrated through multivariate logistic
regression analysis (P<0.001).
Conclusion
Overall, HSI did not improve the diagnostic accuracy above stroboscopy alone. Although
specific laryngeal states such as presbyphonia may be better diagnosed with HSI, further
studies are required to define HSI's precise role in the clinical setting.
Key Words
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Article info
Publication history
Published online: August 01, 2013
Accepted:
April 23,
2013
Footnotes
Presenting Information: This research was presented at The Fall Voice Conference, NYU School of Medicine; October 4–6, 2012; New York, New York.
Identification
Copyright
© 2013 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
