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PURPOSE In this study, the authors aimed to analyze longitudinal data from high-speed digital images in normative subjects using multi-line kymography. METHOD Vocally healthy subjects were divided into young (9 men and 17 women; Mage = 27 years) and older groups (8 men and 12 women; Mage = 73 years). From high-speed digital images of phonation at a conversational frequency kymograms were created at 5 different levels of the vocal fold and were analyzed to determine the opening/closing longitudinal phase difference, open quotient, and speed index. Then age- and gender-related differences of these parameters were analyzed statistically. RESULTS Young women frequently showed a pattern of posterior-to-anterior glottal opening and anterior-to-posterior glottal closure, and older women demonstrated various opening and closing patterns. Both young men and older men were similar to older women. The open quotient was maximal at the most posterior glottal level in young women, but it tended to be maximal at the anterior glottis in the other subgroups. The mean value of the 5 open quotients was largest in young women. The mean speed index had a large negative value in older subjects. CONCLUSION This study provides the first information about age-related differences of longitudinal oscillatory characteristics of the vocal folds obtained with high-speed digital imaging.

Although many quantitative parameters have been devised to describe abnormalities in vocal fold vibration, little is known about the priority of these parameters. We conducted a prospective study using high-speed digital imaging to elucidate disease-specific key parameters (KPs) to characterize the vocal fold vibrations of individual voice disorders. From 304 patients with various voice disorders and 46 normal speakers, high-speed digital imaging of a sustained phonation at a comfortable pitch and loudness was recorded and parameters from visual-perceptual rating, laryngotopography, digital kymography, and glottal area waveform were calculated. Multivariate analysis was then applied to these parameters to elucidate the KPs to explain each voice disorder in comparison to normal subjects. Four key parameters were statistically significant for all laryngeal diseases. However, the coefficient of determination (R2) was very low (0.29). Vocal fold paralysis (8 KPs, R2 = 0.76), sulcus vocalis (4 KPs, R2 = 0.74), vocal fold scarring (1 KP, R2 = 0.68), vocal fold atrophy (6 KPs, R2 = 0.53), and laryngeal cancer (1 KP, R2 = 0.52) showed moderate-to-high R2 values. The results identified different KPs for each voice disorder; thus, disease-specific analysis is a reasonable approach.