Summary
Objective
To analyze the correlation between clinical and video laryngoscopy findings for 89
patients with bilateral vocal fold immobility (BVFI), unilateral vocal fold immobility
(UVFI), and healthy controls by quantitative analysis of normalized laryngeal outlet
(NLO), bowing index (BI), and supraglottic compression (SGC).
Methods
Laryngoscope pictures were taken by two reviewers, and all pictures were standardized
by scaling and calibrating to the same width and height in Image J. Three reviewers used quantitative measures to calculate BI, NLO, and SGC in Image J. We assessed reliability for each measurement by two-factor analysis of variance
(ANOVA) without replication to calculate the interclass correlation coefficient. Analysis
was broken down for each measurement in each group of interest by using a one-way
test. The total glottic area was obtained by calculating the normalized glottal gap
area from each image of maximum glottal closure during phonation.
Results
Overall reliability of all the measurements was 0.69 (IQ 0.58–0.83). Mean NLO from
UVFI, BVFI, and control groups differed significantly. There was no significant difference
between control and BVFI. The total glottic area did not consistently predict normalized
laryngeal outlet values. Mean normalized laryngeal outlet values of UVFI and BVFI
were significantly smaller in the BVFI groups compared with controls and UVFI. BI
values consistently predicted total glottic area in the BVFI group. Static SGC measurement
did not predict a difference between groups.
Conclusion
This is a reliable novel technique, which can be utilized in clinical settings. These
measurements have clinical relevance for managing voice disorders. NLO is the most
accurate measurement correlating with glottal incompetence. BI findings are sufficiently
specific to identify between UVFI and BVFI.
Key Words
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Article info
Publication history
Published online: April 28, 2023
Accepted:
March 29,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
