High-speed laryngeal imaging compared with videostroboscopy in healthy subjects.

OBJECTIVE To describe normal vocal fold vibratory characteristics recorded with high-speed digital imaging (HSV) of the larynx. DESIGN Prospective study of healthy subjects who volunteered to undergo laryngeal HSV and videostroboscopy. Image analysis was randomly assigned to 3 blinded raters. SETTING Community-based clinic with a specialty in laryngology. PARTICIPANTS Fifty healthy subjects aged 21 to 65 years who were nonsmokers and who had no voice problems, laryngopharyngeal reflux, or reactive airway disease. MAIN OUTCOME MEASURES The following characteristics of vibration were described: glottal configuration, phase closure, vibratory symmetry, mucosal wave propagation, amplitude of vibration, and periodicity of vibration. Interrater and intrarater reliabilities were calculated for both imaging modalities. RESULTS The range of findings for each measure is described. The comparison of videostroboscopy ratings with ratings from HSV studies did not reveal any significant difference between the 2 modalities for any of the measures except for the assessment of periodicity. Aperiodic vibratory characteristics were noted on 30% of the videostroboscopy studies (n = 15) and in only 4% of the HSV studies (n = 2) (P <. 001). Although interrater and intrarater agreement were considered to be generally acceptable, a significant rater effect was identified. CONCLUSION This preliminary study describes a range of normal values for vocal fold vibratory characteristics as recorded with laryngeal HSV, providing a basis for comparison of studies in patients with voice problems.