Quantitative Analysis of Vocal Fold Vibration using High-Speed Videoendoscopy in Children with and without Bilateral Lesions

Abstract

Objective: To provide data on the measurable vocal fold vibratory differences in children with and without vocal fold lesions using high-speed videoendoscopy.

Design: Prospective study, 24 participants (8 healthy; 16 with lesions) between the ages of 5 and 10.

Methods: Rigid high-speed videoendoscopy at the rate of 8,000 frames per second was used to examine participants. Four objective vocal fold phase linearity measures were obtained to establish anterior-posterior contact and separation vibratory patterns.

Results: All objective measures showed a difference between nonlesion and bilateral vocal fold lesion groups. Contact-separation patterns in all nonlesion girls and young pre-pubertal boys exhibited an anterior-to-posterior contact and posterior-to-anterior separation; while older boys differed. The objective measures of open quotient, left-right relative phase asymmetry and speed index, showed linear anterior-posterior patterns within the nonlesion group; while the bilateral vocal fold lesion group displayed nonlinear patterns. Patterns in the posterior region of the vocal fold were similar in both groups; while patterns in the anterior region differed.

Conclusions: This study suggests lesions have an effect on the anterior aspect of vocal fold vibratory patterns specifically anterior to the lesions. Age-related differences for males are also evidenced, prompting further investigation of laryngeal development in males and females from childhood to adulthood. This study could serve as a basis for the development of objective clinical measurements of vocal fold vibration in presence of lesions. Further findings could help redefine the theoretical framework of pediatric voice.

Keywords: Children; Cysts; High-speed videoendoscopy; Nodules; Voice; Voice disorders.