Comparison between rigid telescopic and flexible fiberoptic laryngostroboscopy
Rogério Aparecido Dedivitis, Mario Augusto Ferrari de Castro, André Vicente Guimarães, Caio Paschoalin Trindade
Abstract
Introduction: Stroboscopy can uncover significant laryngeal abnormalities in patients with Parkinson’s disease (PD). Rigid telescope and flexible fiberscopy present differing advantages. Objective: To compare the stroboscopic findings observed using rigid telescopy to those obtained through fiberoptic examination. Methods: A prospective study was conducted in order to evaluate 36 patients with PD from January, 2018 to December, 2019. The HY – Degree of Disability Scale was adopted in order to assess individual patients’ levels of impairment. The patients included in this study were grouped- higher than 1.5 on the scale. There were 22 men and 14 women, with ages varying from 41 to 78. Three observers analyzed the recording data, with a protocol for stroboscopic evaluation being adopted. Results: Tremor, open phase closure and vocal fold bowing were the most common findings among patients. Aperiodic voice in 4 cases recommended against stroboscopic analysis. Strong gag reflex in another 3 cases, made evaluation with rigid telescope impossible. The irregularity of the edge, glottic closure, prevalence of the glottic cycle phase, amplitude; mucosal wave; vibratory behavior; phase symmetry, periodicity and movement extension were evaluated by both methods. The vibratory source was exclusively glottic in all cases. Conclusion: Videolaryngostroboscopy can be performed by means of both methods – rigid and fiberoptic examination.
Keywords
References
1. Bless DM, Hirano M, Feder RJ. Videostroboscopic evaluation of the larynx. Ear Nose Throat J. 1987;66(7):289-96. PMid:3622324.
2. Gould WJ, Kojima H, Lambiase A. A technique for stroboscopic examination of the vocal folds using fiberoptics. Arch Otolaryngol. 1979;105(5):285. http:// dx.doi.org/10.1001/archotol.1979.00790170055016. PMid:435155.
3. Swinburn K, Morley R. Parkinson’s disease: management pack - clinicians’s manual. Tolton, Hampshire: Hobbs; 1997.
4. Robbins JA, Logemann JA, Kirshner HS. Swallowing and speech production in Parkinsons disease. Ann Neurol. 1986;19(3):283-7. http://dx.doi.org/10.1002/ ana.410190310. PMid:3963773.
5. Baker KK, Ramig LO, Luschei ES, Smith ME. Thyroarytenoid muscle activity associated with hypophonia in Parkinson disease and aging. Neurology. 1998;51(6):1592-10. http://dx.doi.org/10.1212/WNL.51.6.1592. PMid:9855507.
6. Solomon NP, Hixon T. Speech breathing in Parkinson’s disease. J Speech Hear Disord. 1993;36(2):294-310. http://dx.doi.org/10.1044/jshr.3602.294. PMid:8487522.
7. Schrag A, Ben-Schlomo Y, Quinn N. How common are complications of Parkinson’s disease. J Neurol. 2002;249(4):419-23. http://dx.doi.org/10.1007/s004150200032. PMid:11967646.
8. Stelzig Y, Hochhaus W, Gall V, Henneberg A. Laringeal manifestation in patients with Parkinson’s disease. Laryngorhinootologie. 1999;78(10):544-51. http://dx.doi. org/10.1055/s-1999-8758. PMid:10595338.
9. Verhulst J. L’examen dynamique des cordes vocales: comparaison entre la laryngostroboscopie avec endoscope rigide et la fibroscopie. Rev Laryngol Otol Rhinol (Bord). 1984;105(4):437-9. PMid:6505422.
10. Södersten M, Lindestad PA. A comparison of vocal fold closure in rigid telescopic and flexible fiberoptic laryngostroboscopy. Acta Otolaryngol. 1992;112(1):144-50. http://dx.doi.org/10.3109/00016489209100796. PMid:1575030.
11. Hirano M, Yoshida Y, Yoshida T, Tateishi O. Strobofiberscopic video recording of vocal fold vibration. Ann Otol Rhinol Laryngol. 1985;94(6 Pt 1):588-90. http:// dx.doi.org/10.1177/000348948509400613. PMid:4073736.
12. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17(5):427-42. http://dx.doi.org/10.1212/WNL.17.5.427. PMid:6067254.
13. Cruz WP, Dedivitis RA, Rapoport A, Guimarães AV. Videolaryngostroboscopy following frontolateral laryngectomy with sternohyoid flap. Ann Otol Rhinol Laryngol. 2004;113(2):124-7. http://dx.doi.org/10.1177/000348940411300208. PMid:14994767.
14. Hirano M, Vennard W, Ohala J. Regulation of register pitch and intensity of voice. Folia Phoniatr (Basel). 1970;22(1):1-20. http://dx.doi.org/10.1159/000263363. PMid:5430060.
15. Hirano M. Morphological structure of the vocal cord as a vibrator and its variations. Folia Phoniatr (Basel). 1974;26(2):89-94. http://dx.doi.org/10.1159/000263771. PMid:4845615.
16. Yuceturk AV, Yilmaz H, Egrilmez M, Karaca S. Voice analysis and videolaryngostroboscopy in patients with Parkinson’s disease. Eur Arch Otorhinolaryngol. 2002;259(6):290-3. http://dx.doi.org/10.1007/s00405-002- 0462-1. PMid:12115074.
17. Yanagisawa E, Owens TW, Strothers G, Honda K. Videolaryngoscopy. A comparison of fiberscopic and telescopic documentation. Ann Otol Rhinol Laryngol. 1983;92(5 Pt 1):430-6. http://dx.doi.org/10.1177/000348948309200504. PMid:6625439.
18. Sulica L, Louis ED. Clinical characteristics of essential voice tremor: a study of 34 cases. Laryngoscope. 2010;120(3):516-28. http://dx.doi.org/10.1002/lary.20702. PMid:20066728.
19. Eller R, Ginsburg M, Lurie D, Heman-Ackah Y, Lyons K, Sataloff R. Flexible laryngoscopy: a comparison of fiber optic and distal chip technologies. Part 1: vocal fold masses. J Voice. 2008;22(6):746-50. http://dx.doi.org/10.1016/j. jvoice.2007.04.003. PMid:18207364.
20. Cohen SM, Pitman MJ, Noordzij JP, Courey M. Evaluation of dysphonic patients by general otolaryngologists. J Voice. 2012;26(6):772-8. http://dx.doi.org/10.1016/j. jvoice.2011.11.009. PMid:22285452.
Submitted date:
07/10/2023
Accepted date:
08/04/2023