Article
The Contribution of Videokymography to Phoniatric and Laryngologic Practice
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Authors
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Frantisek Sram
- Zentrum für Betreuung Kranker mit Stimm- und Sprachstörungen sowie Hörfehlern MEDICAL HEALTHCOM GmbH, Resovská 10/491, 181 00 Praha 8, Tschechischen Republik, Tel.: 00420-233 543 385 Fax: 00420 - 233 550 339
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Jan Svec
- National Center for Voice and Speech, The Denver Center for Performing Arts, Denver, USA, 1245 Champa Street, Denver, Colorado 80204, USA, Tel.: 001-303-389 4694, Fax: 001-303-260 7471
| Published: | September 12, 2003 |
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Outline
Abstract
Videokymography (VKG) was introduced into clinical practice in Medical Healthcom Prague in 1996. Since that time it has become an indispensable supplemental diagnostic method to strobovideolaryngoscopy. The total of 3953 examinations have been carried out here using the combination of the two methods. The laryngoscopic images allow evaluation of the vocal folds during respiration and reveal organic pathology. Stroboscopic images allow qualitative evaluation of the vocal fold vibration and the glottal closure and reveal organic and functional disorders in an early stage. VKG supplements these pieces of information by revealing the detailed dynamics of the vocal fold oscillations, which is depicted within a single image. The method enables an objective documentation of the vocal fold vibration in hoarse voices as well as during fast laryngeal events in which stroboscopy fails. It allows discovering subtle functional and early organic changes at specific places of the vocal folds. The combination of the strobovideolaryngoscopy and VKG enables an early diagnostics of functional and organic voice disorders, accurate documentation of the findings and evaluation of the changes as a result of therapy. It can be applied also in studying substitute phonational mechanisms or in examining creation of tone in brass instrument playing. Apart from its clinical value, the method has been helpful in experimental voice research and in development of voice prostheses. The presentation summarizes the authors' experience with VKG and outlines the possibilities of the method in future.
Text
Introduction
Videokymography (VKG), the high-speed method for examination of the vocal fold vibrations, was introduced into clinical practice in the Centre for Communication Disorders, Medical Healthcom, Ltd., Prague in 1996. Since that time it has become an indispensable supplemental diagnostic method to strobovideolaryngoscopy in the Centre. The presentation summarizes the authors' experience with videokymography and outlines the possibilities of the method in phoniatrics in future.
Material and method
The principle of Videokymography:
Videokymography is based on a CCD video camera which was modified to be able to work in two different ways, standard and high-speed. In the standard mode, the camera works as a standard video camera, it delivers 25 frames (i.e., 50 interlaced fields) per second and it provides the standard view of the larynx. In the high-speed mode, the camera delivers images just from a single line with the rate of almost 8000 line images/s. The line images are put below each other and create a videokymographic image displaying the vibratory pattern of the selected part of the vocal folds. In this way it is possible to examine any part of the vocal folds and to store the video images using a standard PAL recorder.
Between 1996 and 2002 the total of 3953 examinations have been carried out by the authors using the combination of the videolaryngostroboscopy and videokymography. The combination of laryngoscopic, stroboscopic and videokymographic images are used for the complex evaluation of the larynx. The laryngoscopic images allow evaluation of the vocal folds during respiration and reveal gross vocal fold mobility and organic pathologies. Stroboscopic images allow qualitative evaluation of the vocal fold vibration and of the glottal closure and reveal organic and functional disorders at an early stage. Videokymography supplements these pieces of information by revealing the microdynamics of the vocal fold oscillations, which is depicted within a single image. The method enables an objective documentation of the vocal fold vibration in hoarse voices as well as during fast laryngeal events (e.g., coughing, etc.) in which stroboscopy fails. It allows discovering subtle functional and early organic changes at specific places of the vocal folds and the displayed asymmetry of the vibration makes it possible to learn about the differences in tension of the two vocal folds. The combination of the strobovideolaryngoscopy and videokymography enables an early diagnostics of functional and organic voice disorders, accurate documentation of the findings and evaluation of the changes as a result of therapy (phonosurgery, etc.). It can be applied also in studying substitute phonational mechanisms or in examining creation of tone in brass instrument playing. Apart from its clinical value, the method has been helpful in experimental voice research and in the development of voice prostheses.
Example: Male, age 77, vocal fold paralysis right [Fig. 1], [Fig. 2].
Acknowledgements
The research has been supported by the Project of the Grant Agency of the Czech Republic GA ČR No. 106/98/K019/4 and by the Project EUREKA E! 2614 NewVoice.
References
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