Efficacy of Videostroboscopy and High-Speed Videoendoscopy to Obtain Functional Outcomes From Perioperative Ratings in Patients With Vocal Fold Mass Lesions

  • Maria E. Powell
    Correspondence
    Address correspondence and reprint requests to Maria E. Powell, Department of Otolaryngology, Vanderbilt University Medical Center, 1161 21st Ave S, MCN S-2224, Nashville, TN 37232.
    Affiliations
    Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee

    Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

    Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio
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  • Dimitar D. Deliyski
    Affiliations
    Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

    Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio

    Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan
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  • Steven M. Zeitels
    Affiliations
    Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts

    Department of Surgery, Harvard Medical School, Boston, Massachusetts
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  • James A. Burns
    Affiliations
    Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts

    Department of Surgery, Harvard Medical School, Boston, Massachusetts
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  • Robert E. Hillman
    Affiliations
    Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts

    Department of Surgery, Harvard Medical School, Boston, Massachusetts

    Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts
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  • Terri Treman Gerlach
    Affiliations
    Voice and Swallowing Center, Charlotte Eye Ear Nose and Throat Associates, Charlotte, North Carolina
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  • Daryush D. Mehta
    Affiliations
    Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts

    Department of Surgery, Harvard Medical School, Boston, Massachusetts

    Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts
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      Summary

      Objectives

      A major limitation of comparing the efficacy of videostroboscopy (VS) and high-speed videoendoscopy (HSV) is the lack of an objective reference by which to compare the functional assessment ratings of the two techniques. For patients with vocal fold mass lesions, intraoperative measures of lesion size and depth may serve as this objective reference. This study compared the relationships between the pre- to postoperative change in VS and HSV visual-perceptual ratings to intraoperative measures of lesion size and depth.

      Design

      Prospective visual-perceptual study with intraoperative measures of lesion size and depth.

      Methods

      VS and HSV samples were obtained preoperatively and postoperatively from 28 patients with vocal fold lesions and from 17 vocally healthy controls. Two experienced clinicians rated amplitude, mucosal wave, vertical phase difference, left-right phase asymmetry, and vocal fold edge on a visual-analog scale using both imaging techniques. The change in perioperative ratings from VS and HSV was compared between groups and correlated to intraoperative measures of lesion size and depth.

      Results

      HSV was as reliable as VS for ratings of amplitude and edge, and substantially more reliable for ratings of mucosal wave and left-right phase asymmetry. Both VS and HSV had mild-moderate correlations between change in perioperative ratings and intraoperative measures of lesion area. Change in function could be obtained in more patients and for more parameters using HSV than VS. Group differences were noted for postoperative ratings of amplitude and edge; however, these differences were within one level of the visual-perceptual rating scale. The presence of asynchronicity in VS recordings renders vibratory features either uninterpretable or potentially distorted and thus should not be rated.

      Conclusions

      Amplitude and edge are robust vibratory measures for perioperative functional assessment, regardless of imaging modality. HSV is indicated for evaluation of subepithelial lesions or if asynchronicity is present in the VS image sequence.

      Key Words

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