Vocal Fold Phase Asymmetries in Patients With Voice Disorders: A Study Across Visualization Techniques Purpose To examine differences in vocal fold vibratory phase asymmetry judged from stroboscopy, high-speed videoendoscopy (HSV), and the HSV-derived playbacks of mucosal wave kymography, digital kymography, and a static medial digital kymography image of persons with hypofunctional and hyperfunctional voice disorders. Differences between the methods of visual judgments and objective ... Research Article
Research Article  |   February 01, 2012
Vocal Fold Phase Asymmetries in Patients With Voice Disorders: A Study Across Visualization Techniques
 
Author Affiliations & Notes
  • Heather Shaw Bonilha
    Medical University of South Carolina, Charleston
    University of South Carolina, Columbia
  • Dimitar D. Deliyski
    Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
    University of South Carolina, Columbia
  • Joanna Piasecki Whiteside
    HealthSouth, Columbia, SC
    University of South Carolina, Columbia
  • Terri Treman Gerlach
    Charlotte Eye, Ear, Nose, and Throat Associates, Charlotte, NC
    University of South Carolina, Columbia
  • Correspondence to Heather Shaw Bonilha: bonilhah@musc.edu
  • Editor: Carol Scheffner Hammer
    Editor: Carol Scheffner Hammer×
  • Associate Editor: Nancy Solomon
    Associate Editor: Nancy Solomon×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Speech, Voice & Prosody / Research Articles
Research Article   |   February 01, 2012
Vocal Fold Phase Asymmetries in Patients With Voice Disorders: A Study Across Visualization Techniques
American Journal of Speech-Language Pathology, February 2012, Vol. 21, 3-15. doi:10.1044/1058-0360(2011/09-0086)
History: Received September 9, 2009 , Revised April 14, 2010 , Accepted September 20, 2011
 
American Journal of Speech-Language Pathology, February 2012, Vol. 21, 3-15. doi:10.1044/1058-0360(2011/09-0086)
History: Received September 9, 2009; Revised April 14, 2010; Accepted September 20, 2011
Web of Science® Times Cited: 10

Purpose To examine differences in vocal fold vibratory phase asymmetry judged from stroboscopy, high-speed videoendoscopy (HSV), and the HSV-derived playbacks of mucosal wave kymography, digital kymography, and a static medial digital kymography image of persons with hypofunctional and hyperfunctional voice disorders. Differences between the methods of visual judgments and objective measures of left-right phase asymmetry were assessed. The findings were compared with those from a previous study with vocally normal speakers.

Method Forty-nine persons with voice disorders underwent stroboscopy and HSV. The HSV images were processed, resulting in 4 different spatial or kymographic displays. Two types of phase asymmetries, left-right and anterior-posterior, were visually rated. Objective measures of left-right phase asymmetry were obtained.

Results From stroboscopy, the HSV playback, and the HSV-derived playbacks, left-right phase symmetry was judged to be symmetrical in 41%, 32%, and 19% of cases, respectively. This difference in playbacks was not seen for anterior-posterior asymmetry. Correlation between visual judgments and objective measures was mild for stroboscopy and moderate to high for all HSV-based playbacks.

Conclusions The use of kymography appears important for judgments of phase asymmetry. Stroboscopy appears to be sensitive, but possibly not specific, to phase asymmetries. Further development of objective measures is warranted for this feature.

Acknowledgments
This project was supported by National Institute on Deafness and Other Communication Disorders (NIDCD) Research Grant R01 DC007640. Major parts of this research have been conducted by the authors at the Department of Communication Sciences and Disorders at the University of South Carolina, where this NIDCD grant was originally awarded. We would like to thank Lori Ellen Sutton, Susan Hanks, and Cara Sauder for their role in data collection. Portions of this study were presented at the American Laryngological Association Combined Otolaryngological Spring Meeting in Orlando, FL, in May 2008.
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