title: Vocal Fold Vibratory Changes Following Surgical Intervention.
abstract: High-speed videoendoscopy (HSV) captures direct cycle-to-cycle visualization of vocal fold movement in real time. This ultrafast recording rate is capable of visualizing the vibratory motion of the vocal folds in severely disordered phonation and provides a direct method for examining vibratory changes after vocal fold surgery. The purpose of this study was to examine the vibratory motion before and after surgical intervention. HSV was captured from two subjects with identifiable midvocal fold benign lesions and six subjects with highly aperiodic vocal fold vibration before and after phonosurgery. Digital kymography (DKG) was used to extract high-speed kymographic vocal fold images sampled at the midmembranous, anterior 1/3, and posterior 1/3 region. Spectral analysis was subsequently applied to the DKG to quantify the cycle-to-cycle movements of the left and the right vocal fold, expressed as a spectrum. Before intervention, the vibratory spectrum consisted of decreased and flat-like spectral peaks with robust power asymmetry. After intervention, increases in spectral power and decreases in power symmetry were noted. Spectral power increases were most remarkable in the midmembranous region of the vocal fold. Surgical modification resulted in improved lateral excursion of the vocal folds, vibratory function, and perceptual measures of Voice Handicap Index-10. These changes in vibratory behavior trended toward normal vocal fold vibration.
authors.affiliation: Department of Rehabilitation, NYU Lutheran Medical Center, Brooklyn, New York. Electronic address: wc2416@tc.columbia.edu.
authors.forename: Wenli
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Peak
authors.initials: P
authors.lastname: Woo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, California.
authors.forename: Thomas
authors.initials: T
authors.lastname: Murry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D006801:Humans; D007734:Kymography; D007818:Laryngeal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007828:Laryngoscopy; D008875:Middle Aged; D010699:Phonation; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014732:Vibration; D014741:Video Recording; D014827:Vocal Cords / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality
keywords: High-speed videoendoscopy; Phonosurgery; Spectrum; Vocal fold vibration