Videostrobokymography in the diagnosis of laryngeal diseases

Introduction. Videolaryngoscopy and videolaryngostroboscopy are the “gold standard” for the diagnosis of laryngeal diseases. During a videolaryngoscopy, an anatomical and functional assessment of the state of the larynx is performed. Videolaryngostroboscopy visualizes the vibratory cycle of the vocal folds in order to provide a more detailed functional assessment. Videostrobokymography allows to perform a qualitative and quantitative analysis of the vibratory cycle.

Aim. To evaluate the indicators of videostrobokymography in functional and organic dysphonia.

Materials and methods. 9 patients were examined. In one case, there was no pathology of the larynx. Among the functional disorders, two cases of hypofunctional and one of hyperfunctional dysphonia are presented. Organic diseases: chronic catarrhal laryngitis, Reinke’s edema, vocal fold nodules, vocal fold polyp, vocal fold injury after phonosurgery. Videolaryngoscopy, videolaryngostroboscopy, and videostrobokymography were performed. The strobokimograms were evaluated qualitatively by the presence of periodic oscillations of the vocal folds, phase and amplitude symmetry, mucous wave, the shape of lateral and medial peaks, and the shape of the gap in the opening phase. For the quantitative analysis, the opening quotient (OQ) was determined, which objectively reflected the duration of the opening phase.

Results. Normally, phase and amplitude symmetry were preserved, the mucous wave was visualized, lateral and medial peaks of vibrations were pronounced, the gap in the opening phase was in the shape of a rhomb, OQ was 0.5. Pathological changes included: a decrease in the amplitude of vibrations, an increase or decrease in the mucous wave, phase and amplitude asymmetry, a change in the shape of lateral and medial peaks, a change in the shape of the gap in the opening phase. The OQ index varied from 0.42 to 1 depending on the duration of the opening phase in various diseases of the larynx.

Conclusions. Videostrobokymography makes it possible to assess the indicators of the vibratory cycle in more detail, conduct a graphical analysis, compare the picture at different levels of the glottis, and obtain objective data. The method can be used in the in-depth diagnosis and evaluation of the results of treatment of diseases of the larynx in addition to videolaryngostroboscopy.

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