Differences in glottal closure and visibility of the anterior commissure during rigid-90°, rigid-70° and flexible laryngostroboscopy
| Autor: | Roland Paulus, Matthias Leonhard, Guan-Yuh Ho, Annabella Kurz, Berit Schneider-Stickler |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Folia Phoniatrica et Logopaedica. |
| ISSN: | 1421-9972 1021-7762 |
| DOI: | 10.1159/000530454 |
| Popis: | Objectives The conventional rigid-90° and rigid-70° laryngostroboscopy has been so far considered the gold standard in assessing the vibratory behavior of the vocal folds and the glottal closure configuration during phonation. Meanwhile this rigid laryngostroboscopy is more and more replaced by flexible chip-on-tip systems. Aim of this study was to evaluate the influence of these different endoscopic techniques on glottal closure configuration and on visibility of the complete focal fold length including anterior commissure during phonation. Methods Twenty-one euphonic subjects were enrolled (mean age 34,6 9,5; m=10, f=11). They were examined with the three laryngoscopic techniques (conventional rigid-90°, rigid-70° and flexible chip-on-tip laryngoscopy during low and high voice pitch with soft and loud voice intensity). For evaluating the degree of glottal closure, a modified classification of Södersten et al. was applied and the visibility of the anterior commissure was evaluated. The correlation of the three endoscopic techniques was assessed with Cohen and Fleiss' kappa. Results In even low loud phonation, the rigid-90° and rigid-70° endoscopies revealed a complete closure of the glottis in only 47,6 % of subjects, but with flexible endoscopy in 81 %. The complete vocal fold length with anterior commissure was best visible with flexible endoscopy in 90,5 % in low soft and high soft phonation. The rigid-90° endoscopy showed a slight agreement in comparison with the flexible endoscopy in regard to the types of vocal fold closure with a Cohen’s kappa coefficient k = 0,199. The rigid-90° endoscopy showed an almost perfect agreement with k = 0,84 when compared to the rigid-70° endoscopy. The flexible endoscopy compared to the rigid-70° endoscopy showed a fair agreement with k = 0,346. Conclusion We found mainly corresponding results in both rigid-90° and rigid-70° endoscopic techniques which can be explained by the same transoral approach with the tongue pulled out, whereas the flexible transnasal endoscopy mainly gives a better view on the anterior commissure. The influence of transorally or transnasally guided endoscopic techniques need to be considered in interpretation of laryngostroboscopic parameters like vocal fold closure and supraglottal hyperactivity. |
| Databáze: | OpenAIRE |
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