Visual and Automatic Evaluation of Vocal Fold Mucosal Waves Through Sharpness of Lateral Peaks in High-Speed Videokymographic Images

  • S. Pravin Kumar
    Correspondence
    Address correspondence and reprint requests to S. Pravin Kumar or Jan G. Švec, Voice Research Lab, Department of Biophysics, Faculty of Science, Palacký University, 17. listopadu 12, Olomouc 77416, Czech Republic.
    Affiliations
    Voice Research Lab, Department of Biophysics, Faculty of Science, Palacký University, Olomouc, Czech Republic
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  • Ketaki Vasant Phadke
    Affiliations
    Voice Research Lab, Department of Biophysics, Faculty of Science, Palacký University, Olomouc, Czech Republic
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  • Jitka Vydrová
    Affiliations
    Voice and Hearing Centre, Medical Healthcom Ltd., Prague, Czech Republic
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  • Adam Novozámský
    Affiliations
    Department of Image Processing, Institute of Information Theory and Automation of the Czech Academy of Sciences, Prague, Czech Republic
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  • Aleš Zita
    Affiliations
    Department of Image Processing, Institute of Information Theory and Automation of the Czech Academy of Sciences, Prague, Czech Republic
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  • Barbara Zitová
    Affiliations
    Department of Image Processing, Institute of Information Theory and Automation of the Czech Academy of Sciences, Prague, Czech Republic
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  • Jan G. Švec
    Correspondence
    Address correspondence and reprint requests to S. Pravin Kumar or Jan G. Švec, Voice Research Lab, Department of Biophysics, Faculty of Science, Palacký University, 17. listopadu 12, Olomouc 77416, Czech Republic.
    Affiliations
    Voice Research Lab, Department of Biophysics, Faculty of Science, Palacký University, Olomouc, Czech Republic
    Search for articles by this author
Published:October 10, 2018DOI:https://doi.org/10.1016/j.jvoice.2018.08.022

      Abstract

      Introduction

      The sharpness of lateral peaks is a visually helpful clinical feature in high-speed videokymographic (VKG) images indicating vertical phase differences and mucosal waves on the vibrating vocal folds and giving insights into the health and pliability of vocal fold mucosa. This study aims at investigating parameters that can be helpful in objectively quantifying the lateral peak sharpness from the VKG images.

      Method

      Forty-five clinical VKG images with different degrees of sharpness of lateral peaks were independently evaluated visually by three raters. The ratings were compared to parameters obtained by automatic image analysis of the vocal fold contours: Open Time Percentage Quotients (OTQ) and Plateau Quotients (PQ). The OTQ parameters were derived as fractions of the period during which the vocal fold displacement exceeds a predetermined percentage of the vibratory amplitude. The PQ parameters were derived similarly but as a fraction of the open phase instead of a period.

      Results

      The best correspondence between the visual ratings and the automatically derived quotients were found for the OTQ and PQ parameters derived at 95% and 80% of the amplitude, named OTQ95, PQ95, OTQ80 and PQ80. Their Spearman's rank correlation coefficients were in the range of 0.73 to 0.77 (P < 0.001) indicating strong relationships with the visual ratings. The strengths of these correlations were similar to those found from inter-rater comparisons of visual evaluations of peak sharpness.

      Conclusion

      The Open time percentage and Plateau quotients at 95% and 80% of the amplitude stood out as the possible candidates for capturing the sharpness of the lateral peaks with their reliability comparable to that of visual ratings.

      Key Words

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      REFERENCES

        • Hirano M.
        Clinical Examination of Voice.
        Springer-Verlag, Wien, Austria1981
        • Titze IR
        The physics of small‐amplitude oscillation of the vocal folds.
        J Acoust Soc Am. 1988; 83: 1536-1552
        • McGowan R
        An analogy between the mucosal waves of the vocal folds and wind waves on water.
        Haskins Lab Status Rep Speech Res. 1990; 101: 243-249
        • Yumoto E
        • Kurokawa H
        • Okamura H
        Vocal fold vibration of the canine larynx: observation from an infraglottic view.
        J Voice. 1991; 5: 299-303
        • Titze IR
        • Jiang JJ
        • Hsiao T-Y.
        Measurement of mucosal wave propagation and vertical phase difference in vocal fold vibration.
        Ann Otol Rhinol Laryngol. 1993; 102: 58-63
        • Berke GS
        • Gerratt BR
        Laryngeal biomechanics: an overview of mucosal wave mechanics.
        J Voice. 1993; 7: 123-128
        • Boessenecker A
        • Berry DA
        • Lohscheller J
        • et al.
        Mucosal wave properties of a human vocal fold.
        Acta Acust united Ac. 2007; 93: 815-823
        • Krausert CR
        • Olszewski AE
        • Taylor LN
        • et al.
        Mucosal wave measurement and visualization techniques.
        J Voice. 2011; 25: 395-405
        • Hirano M
        • Bless DM
        Videostroboscopic Examination of the Larynx.
        Singular Publishing Group, San Diego, California1993
        • Švec JG
        • Šram F
        • Schutte HK
        Videokymography.
        in: Fried M Ferlito A 3 ed. The Larynx. Vol 1. Plural Publishing, San Diego, CA2009: 253-271
        • Bless DM
        • Hirano M
        • Feder RJ
        Videostroboscopic evaluation of the larynx.
        Ear Nose Throat J. 1987; 66: 289-296
      1. Hiroto I. Vibration of vocal cords: an ultra high-speed cinematographic study (film). Kurume, Japan: Department of otolaryngology, Kurume University; 1968.

        • Berry DA
        • Montequin DW
        • Tayama N
        High-speed digital imaging of the medial surface of the vocal folds.
        J Acoust Soc Am. 2001; 110: 2539-2547
        • Döllinger M
        • Berry DA
        • Kniesburges S
        Dynamic vocal fold parameters with changing adduction in ex-vivo hemilarynx experiments.
        J Acoust Soc Am. 2016; 139: 2372-2385
        • Herbst CT
        • Hampala V
        • Garcia M
        • et al.
        Hemi-laryngeal setup for studying vocal fold vibration in three dimensions.
        J Vis Exp. 2017; 129: e55303https://doi.org/10.3791/55303
        • Jing B
        • Ge Z
        • Wu L
        • et al.
        Visualizing the mechanical wave of vocal fold tissue during phonation using electroglottogram-triggered ultrasonography.
        J Acoust Soc Am. 2018; 143: EL425-EL429
        • Ishizaka K
        • Flanagan J
        Synthesis of voiced sounds from a two-mass model of the vocal cords.
        Bell Syst Tech J. 1972; 51: 1233-1268
        • Titze IR
        Comments on the myoelastic-aerodynamic theory of phonation.
        J Speech Hear Reas. 1980; 23: 495-510
        • Titze IR.
        Principles of Voice Production (Second Printing).
        National Center for Voice and Speech, Iowa City, IA2000
        • Dejonckere PH
        • Bradley P
        • Clemente P
        • et al.
        A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques.
        Eur Arch Otorhinolaryngol. 2001; 258: 77-82
        • Poburka BJ
        A new stroboscopy rating form.
        J Voice. 1999; 13: 403-413
        • Deliyski DD
        • Petrushev PP
        • Bonilha HS
        • et al.
        Clinical implementation of laryngeal high-speed videoendoscopy: challenges and evolution.
        Folia Phoniatr Logop. 2008; 60: 33-44
        • Voigt D
        • Döllinger M
        • Eysholdt U
        • et al.
        Objective detection and quantification of mucosal wave propagation.
        J Acoust Soc Am. 2010; 128: EL347-EL353
        • Kaneko M
        • Shiromoto O
        • Fujiu-Kurachi M
        • et al.
        Optimal duration for voice rest after vocal fold surgery: randomized controlled clinical study.
        J Voice. 2017; 31: 97-103
        • Poburka BJ
        • Patel RR
        • Bless DM
        Voice-vibratory assessment with laryngeal imaging (VALI) form: reliability of rating stroboscopy and high-speed videoendoscopy.
        J Voice. 2017; 31: 513.e1-513.e14
        • El-Demerdash A
        • Fawaz SA
        • Sabri SM
        • et al.
        Sensitivity and specificity of stroboscopy in preoperative differentiation of dysplasia from early invasive glottic carcinoma.
        Eur Arch Otorhinolaryngol. 2015; 272: 1189-1193
        • Zacharias SRC
        • Deliyski DD
        • Gerlach TT
        Utility of laryngeal high-speed videoendoscopy in clinical voice assessment.
        J Voice. 2018; 32: 216-220
        • Patel RR
        • Awan SN
        • Barkmeier-Kraemer J
        • et al.
        Recommended minimum protocols for instrumental assessment of voice: American Speech-Language Hearing Association Committee on Instrumental Voice assessment protocols.
        Am J Speech Lang Pathol. 2018; 27: 887-905
        • Švec JG
        • Schutte HK
        Kymographic imaging of laryngeal vibrations.
        Curr Opin Otolaryngol Head Neck Surg. 2012; 20: 458-465
        • Švec JG
        • Šram F
        • Schutte HK
        Videokymography in voice disorders: what to look for.
        Ann Otol Rhinol Laryngol. 2007; 116: 172-180
        • Švec JG
        • Frič M
        • Šram F
        • Schutte HK
        Mucosal waves on the vocal folds: conceptualization based on videokymography.
        Fifth International Workshop on Models and Analysis of Vocal Emissions for Biomedical Applications. Firenze University Press, Firenze, Italy2007: 171-172
        • Švec JG
        • Šram F
        Videokymographic examination of voice.
        in: Ma EPM Yiu EML Handbook of Voice Assessments. Plural Publishing, San Diego, CA2011: 129-146
        • Sundberg J
        • Högset C
        Voice source differences between falsetto and modal registers in counter tenors, tenors and baritones.
        Logoped Phoniatr Vocol. 2001; 26: 26-36
        • Phadke KV
        • Vydrová J
        • Domagalská R
        • et al.
        Evaluation of clinical value of videokymography for diagnosis and treatment of voice disorders.
        Eur Arch Otorhinolaryngol. 2017; 274: 3941-3949
        • Vydrová J
        • Švec JG
        • Šram F
        Videokymography (VKG) in laryngologic practice.
        J Macrotrends Health Med. 2015; 3: 87-95
        • Yamauchi A
        • Yokonishi H
        • Imagawa H
        • et al.
        Quantification of vocal fold vibration in various laryngeal disorders using high-speed digital imaging.
        J Voice. 2016; 30: 205-214
        • Yamauchi A
        • Yokonishi H
        • Imagawa H
        • et al.
        Visualization and estimation of vibratory disturbance in vocal fold scar using high-speed digital imaging.
        J Voice. 2016; 30: 493-500
        • Švec JG
        • Sundberg J
        • Hertegard S
        Three registers in an untrained female singer analyzed by videokymography, strobolaryngoscopy and sound spectrography.
        J Acoust Soc Am. 2008; 123: 347-353
        • Shaw HS
        • Deliyski DD
        Mucosal wave: a normophonic study across visualization techniques.
        J Voice. 2008; 22: 23-33
        • Andrade-Miranda G
        • Bernardoni NH
        • Godino-Llorente JI
        Synthesizing the motion of the vocal folds using optical flow based techniques.
        Biomed Signal Process Control. 2017; 34: 25-35
        • Chen W
        • Woo P
        • Murry T
        Spectral analysis of digital kymography in normal adult vocal fold vibration.
        J Voice. 2014; 28: 356-361
        • Chen W
        • Woo P
        • Murry T
        Vocal fold vibratory changes following surgical intervention.
        J Voice. 2016; 30: 224-227
        • Chen W
        • Woo P
        • Murry T
        Vocal fold vibration following surgical intervention in three vocal pathologies: a preliminary study.
        J Voice. 2017; 31: 610-614
        • Jiang JJ
        • Chang CIB
        • Raviv JR
        • et al.
        Quantitative study of mucosal wave via videokymography in canine larynges.
        Laryngoscope. 2000; 110: 1567-1573
        • Yamauchi A
        • Yokonishi H
        • Imagawa H
        • et al.
        Quantitative analysis of digital videokymography: a preliminary study on age- and gender-related difference of vocal fold vibration in normal speakers.
        J Voice. 2015; 29: 109-119
        • Jiang JJ
        • Zhang Y
        • Kelly MP
        • et al.
        An automatic method to quantify mucosal waves via videokymography.
        Laryngoscope. 2008; 118: 1504-1510
        • Chodara AM
        • Krausert CR
        • Jiang JJ
        Kymographic characterization of vibration in human vocal folds with nodules and polyps.
        Laryngoscope. 2012; 122: 58-65
        • Krausert CR
        • Ying D
        • Zhang Y
        • et al.
        Quantitative study of vibrational symmetry of injured vocal folds via digital kymography in excised canine larynges.
        J Speech Lang Hear Res. 2011; 54: 1022-1038
        • Li L
        • Zhang Y
        • Maytag AL
        • et al.
        Quantitative study for the surface dehydration of vocal folds based on high-speed imaging.
        J Voice. 2015; 29: 403-409
        • Regner MF
        • Robitaille MJ
        • Jiang JJ
        Interspecies comparison of mucosal wave properties using high-speed digital imaging.
        Laryngoscope. 2010; 120: 1188-1194
        • Zhang Y
        • Huang N
        • Calawerts W
        • et al.
        Quantifying the subharmonic mucosal wave in excised larynges via digital kymography.
        J Voice. 2017; 31: 123.e7-123.e13
        • Bonilha HS
        • Deliyski DD
        • Gerlach TT
        Phase asymmetries in normophonic speakers: visual judgments and objective findings.
        Am J Speech Lang Pathol. 2008; 17: 367-376
      2. Novozamsky A, Sedlar J, Zita A, et al. Image analysis of videokymographic data. 2015 IEEE International Conference on Image Processing (ICIP), 2015,78–82.

      3. Švec JG, Švecová H, Herbst C, et al. Evaluation protocol for videokymographic images. (Ms Access software application). Groningen, the Netherlands: Groningen Voice Research Lab, University of Groningen. 2007.

        • Woo P
        Quantification of videostrobolaryngoscopic findings–measurements of the normal glottal cycle.
        Laryngoscope. 1996; 106: 1-27
        • Mehta DD
        • Zañartu M
        • Quatieri TF
        • et al.
        Investigating acoustic correlates of human vocal fold vibratory phase asymmetry through modeling and laryngeal high-speed videoendoscopy.
        J Speech Lang Hear Res. 2011; 130: 3999-4009
        • Hiroto I
        The mechanism of phonation; its pathophysiological aspects.
        Nippon Jibiinkoka Gakkai Kaiho. 1966; 69: 2097-2106
        • Timcke R
        • von Leden H
        • Moore P
        Laryngeal vibrations - measurements of the glottic wave .I. The normal vibratory cycle.
        AMA Arch Otolaryngol. 1958; 68: 1-19
        • Qiu Q
        • Schutte H
        • Gu L
        • et al.
        An automatic method to quantify the vibration properties of human vocal folds via videokymography.
        Folia Phoniatr Logop. 2003; 55: 128-136
        • Lohscheller J
        • Švec JG
        • Döllinger M
        Vocal fold vibration amplitude, open quotient, speed quotient and their variability along glottal length: kymographic data from normal subjects.
        Logoped Phoniatr Vocol. 2013; 38: 182-192
        • Subbaraj PK
        • Švec JG
        Kinematic model for simulating mucosal wave phenomena on vocal folds.
        in: Manfredi C. MAVEBA 2017: Models and Analysis of Vocal Emissions for Biomedical Applications. 10th International Workshop. Firenze University Press, Firenze2017: 115-118