Visual-perceptive assessment of glottic characteristics of vocal nodules by means of high-speed videoendoscopy

Highlights

• Vocal nodules present mid-posterior triangular chink.

• Vocal nodules present irregular free edge contour.

• In vocal nodules glottal cycle is symmetric and periodic.

Abstract

Objective

Visual-perceptive assessment of glottic characteristics of vocal nodules by means of high-speed videoendoscopy.

Methods

Descriptive observational research with convenience sampling of five laryngeal videos of women with an average age of 25 years. The diagnosis of vocal nodules was defined by two otolaryngologists, with 100% intra-rater agreement and 53.40% inter-rater agreement and five otolaryngologists as judge assessed the laryngeal videos based on an adapted protocol. The statistical analysis calculated measures of central tendency and dispersion, as well as percentage. The AC1 coefficient was used for agreement analysis.

Results

In high-speed videoendoscopy imaging, vocal nodules are characterized by amplitude of the mucosal wave and muco-undulatory movement with magnitude between 50% and 60%. Non-vibrating segments of vocal folds are scarce, and the glottal cycle does not show a predominant phase, it is symmetric and periodic. Glottal closure is characterized by the presence of a mid-posterior triangular chink (double chink or isolated mid-posterior triangular chink), without movement of supraglottic laryngeal structures, with irregular contour of the free edge of vocal folds, which are vertically on-plane.

Conclusion

Vocal nodules present mid-posterior triangular chink and irregular free edge contour. Amplitude and mucosal wave were partially reduced.

Level of evidence: Level 4 (Case-series).

Keywords
Vocal cords; Vocal cord dysfunction; Laryngoscopy; Endoscopy