Blog Archives

Frame by Frame Analysis of Glottic Insufficiency Using Laryngovideostroboscopy

FBFA appears to be a simple objective method for the novice or experienced LVS interpreter, by which one can suspect subtle GI. Because of the inherent physical properties by which LVS gives an “illusionary” representation of the glottic cycle, the FBFA technique remains a theoretical tool. Future studies using high-speed digital imaging are needed to validate this useful technique.

from the Journal of Voice

Short term effect of hubble-bubble smoking on voice

Conclusion: Even 30 minutes of hubble-bubble smoking can cause a drop in vocal pitch and an increase in laryngeal secretions and vocal fold vasodilation.

from the Journal of Laryngology and Otology

Endoscopic and Stroboscopic Presentation of the Larynx in Male-to-Female Transsexual Persons

MFT speakers who reported a “passing” feminine voice had glottal gap configurations more similar to anatomic females than males and tended toward more open phase closure ratios, perhaps consistent with breathy or soft voice production. Indications of vocal hyperfunction were present for all participants either by self-report or on the laryngeal examination.

from the Journal of Voice

Commentary on Why Laryngeal Stroboscopy Really Works: Clarifying Misconceptions Surrounding Talbot’s Law and the Persistence of Vision

Conclusions: References to Talbot’s law and the persistence of vision are not relevant to the generation of stroboscopic images. The critical visual phenomena are the flicker-free perception of light intensity and the perception of apparent motion from sampled images. A complete understanding of how laryngeal stroboscopy works will aid in better interpreting clinical findings during voice assessment.

from the Journal of Speech, Language, and Hearing Research

Evaluation of Stroboscopic Signs

The results of the study support the concept that a small set of stroboscopic ratings is an adequate representation of the information derived from the original, more comprehensive sign rating protocol. A focused rating system may provide an efficient method for stroboscopic evaluation, contributing to the differentiation of various vocal fold pathologies and correlating to clinician ratings of severity of dysphonia.

from the Journal of Voice

Vocal fold mucus aggregation in vocally normal speakers

Vocal fold mucus aggregation is common in persons with voice disorders. The normality of vocal fold mucus aggregation in vocally normal speakers is not known. The purpose of this study was to preliminarily ascertain the presence, type, thickness, location, and pooling of mucus aggregation in vocally normal speakers. An additional aim was to evaluate whether the features of mucus aggregation are more easily identified using stroboscopy or high-speed videoendoscopy (HSV). These aims were accomplished by visually rating a systematically collected database of stroboscopy and HSV recordings from 52 normophonic speakers. Results revealed 97% of normophonic speakers presented with visible mucus aggregation. Statistically significant differences were found for judgments of HSV compared to stroboscopy on the parameters of type 1 mucus, not apparent and mild thickness, not apparent pooling, and all three locations. Two main conclusions can be drawn from this study: 1) normophonic speakers commonly have mucus aggregation and 2) mucus aggregation is identified more often through stroboscopy than HSV.

from Logopedics Phoniatrics Vocology

Flexible Laryngoscopy: A Comparison of Fiber Optic and Distal Chip Technologies—Part 2: Laryngopharyngeal Reflux

Part 1 of this paper compared fiber optic (FO) and distal chip (DC) flexible technologies in the diagnosis of vocal fold masses and mucosal wave abnormalities. Part 2 of this study was designed to evaluate the usefulness of FO and DC flexible imaging in the diagnosis of laryngopharyngeal reflux (LPR) disease. Thirty-four consecutive patients were examined with either FO or DC flexible stroboscopy followed immediately by rigid stroboscopy. Rigid stroboscopy was considered the “gold-standard” for this study. All stroboscopy segments were evaluated by two laryngologists, an otolaryngologist, a laryngology fellow, and an otolaryngology resident for physical findings of LPR using the Reflux Finding Score (RFS) and Posterior Erythema Grade (PE grade). Both flexible systems underrepresented the physical findings of LPR compared to the rigid examination, but the FO system was frequently more accurate than the DC system. For PE grade, agreement with the rigid endoscope was 95% for the FO system and 73% for the DC system. Total RFSs for both flexible systems were significantly different than RFSs from the corresponding rigid examinations (P = 0.001). Raters who used the RFS more often were more consistent. More severe PE grade scores correlated well with increasing RFSs. The number of patients diagnosed with LPR (RFS > 7) showed that despite differences in the category scores, the FO and DC were almost identical in how much LPR was diagnosed compared with their matched rigid examination. Because both flexible platforms significantly underrepresented reflux signs, we recommend that a rigid laryngeal telescope be used when examining the larynx for signs of LPR. If this is not available, these data suggest that a high-quality FO endoscope may be more accurate than a DC endoscope for most otolaryngologists.

from the Journal of Voice