Subjective And Objective Evaluation And The Application Of Videostrobokymography In Patients With Neurogenic Unilateral Vocal Cord Paralysis

Objective:To explore the subjective acoustic characteristics and evaluate the VHI-10of neurogenic unilateral vocal cord paralysis, and evaluate the effect of acoustic analysis method on the diagnosis of vocal cord paralysis. Using videostroboscopy to explore the feasibility of Videostrobokymography (VSK) for assessment of vocal cord vibration in patients with vocal cord paralysis.Methods:A voice acoustic analysis was applied to22patients of neurogenic unilateral vocal cord paralysis and30healthy control subjects, to analyse and compare the pitch perturbation (jitter), amplitude perturbation (shimmer), fundamental frequency (FO), as well as maximum phonatory time (MPT) as objective items to evaluate the differences between two groups. The spectrographic characteristics (harmonic waves, formants and noise) were analysed. The simplified Chinese version of VHI-10was applied on those patients as subjective evaluate. All the patients’stroboscopic videos were recorded. Values of open quotient (OQ) were obtained together with kymograms to study the characteristics of VSK in vocal cord paralysis group. Datas were analysed as two independent samples t-test by SPSS20.0statistical software. P value<0.05was considered a statistically significant.Results:1.The two groups showed significant differences for jitter, shimmer, the patients with vocal cord paralysis were higher than the control group, the difference was statistically significant(P<0.05). The FO of vocal cord paralysis group was slightly lower than the control group, but the difference was not statistically significant(P>0.05).2.The pathologic spectrograph showed decrease or loss of harmonic waves, the second and third formants(F2、F3) were almost disappeared and increase of noise in middle and high frequencies. There was harmonic waves and formant(F1) In low frequency, but were irregular and interruption.3. The MPT of vocal cord paralysis group was obviously lower than the control group, the difference was statistically significant(P<0.05).4. the VHI-10of the vocal cord paralysis patients was higher than normal group, the difference was statistically significant. The voice status affected the patient’s voice function, physical and emotional.5. In control group, phase symmetry of them was mainly symmetrical, and mucosal waves were regular. Phase symmetry was asymmetrical in vocal cord paralysis group on corresponding kymograms. Phase symmetry was asymmetrical in16cases (72.73%) out of the22vocal cord paralysis patients. It included7cases (31.82%) which mucosal waves were observed in paralysed vocal cords, closures of glottal gaps were not observed, the mucosal waves were attenuated on bilateral vocal cords; In other9cases(40.91%) without mucosal waves on paralyzed vocal cords, closures of glottal gaps were not observed, mucosal waves on contralateral vocal cords were observed, but were obviously attenuated. From the VSK in vocal cord paralysis patients, closures of glottal gaps were not observed, the OQ was equal to1, the values of OQ were bigger than those in control group.Conclusion:1.The voice acoustic parameters can be used as a quantitative index for evaluating the neurogenic unilateral vocal cord paralysis patients, and can obviously reflect the position and degree of glottal closure of paralytic vocal cord. Spectrograph displayed the acoustic characteristics of the patients.2.Through the VH1-10, vocal cord paralkysis patients in the total score was significantly higher than the normal. That voice disorders can cause different degree of psychological and social problems, and affect the patients’ quality of life.3. Observed the vibration of vocal cord from VSK, the phase symmetry and mucosal wave of the neurogenic unilateral vocal cord paralysis patients were obviously abnormal from normal people, also can make us more understanding of such cases.