Efficacy of Videostroboscopy and High-Speed Videoendoscopy to Obtain Functional Outcomes From Perioperative Ratings in Patients With Vocal Fold Mass Lesions.
Maria E Powell, Dimitar D Deliyski, Steven M Zeitels and 4 others
PMID 31005449WHAT IT FOUND
HSV+DKG gave more usable and more consistent ratings of vocal fold vibration than videostroboscopy.
Videostroboscopy could not rate 14.5% of observations because images were asynchronous, so HSV+DKG may help when stroboscopy fails.
Key findings
01Raters were confident in 78.5% of HSV+DKG observations and could not rate 2.95%, compared with 54.3% confidence and 14.5% unrateable for videostroboscopy.
02Raters agreed more when scoring vocal fold features with HSV+DKG than with videostroboscopy, with agreement of 84%-100% versus 60%-94%.
03Comparing preoperative and postoperative recordings, HSV+DKG ratings improved significantly for left and right amplitude and left and right vocal fold edge, while videostroboscopy ratings improved significantly only for left vocal fold edge.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only 28 patients with dysphonia and 17 healthy controls, and only two raters. The videostroboscopy and HSV+DKG samples came from different phonation tasks and durations: videostroboscopy showed 2-4 seconds, while HSV+DKG showed 43 ms. Postoperative testing occurred at an average of 3.5 weeks, so ongoing healing and swelling could have affected ratings. Eight of 28 patients had no calibrated intraoperative images, so lesion-size correlations were based on 20 patients and 25 vocal folds. Raters had experience with videostroboscopy but less experience with HSV+DKG. Vertical phase difference was not reliably rated and was excluded. The reported outcomes were visual-perceptual ratings and intraoperative lesion measurements, not patient voice outcomes.
The easy way to misread this
Do not conclude that HSV+DKG is proven to improve diagnosis, treatment, or patient voice outcomes. It improved how consistently clinicians could rate some vocal fold features, but the study did not test whether those ratings changed care.