Videokymographic index of glottic function: an analysis of diagnostic accuracy

Abstract

Purpose To develop the Videokymographic Index of Glottic Function (VIGF), a composite indicator from digital videokymography parameters, captured by high-speed videolaryngoscopy exams of women with and without laryngeal alterations of behavioral etiology. Methods The sample consisted of 92 women aged between 18 and 45 years. Fifty-five (55) women with behavioral dysphonia, presenting with laryngeal and voice alterations, and thirty-seven (37) women without any laryngeal and voice alterations. Voice evaluation was performed by consensus via an auditory-perceptual analysis of the sustained vowel /a/ at a habitual pitch and loudness. Voice classification was obtained by means of a general degree of dysphonia, where G0 indicated neutral voice quality and G1 to G3 indicated altered voice quality. Laryngeal images were captured via digital videokymography analysis of a sustained vowel /i/ at a habitual pitch and loudness. The VIGF was based on the midpoint of the glottal region for analysis. Logistic regression was performed using the MINITAB 19 program. Results Logistic regression was composed of two stages: Stage 1 consisted of the analysis of all variables, where the maximum opening and closed quotient variables showed statistical significance (p-value <0.05) and the model was well adjusted according to the Hosmer-Lemeshow test (p-value=0.794). Stage 2 consisted of the re-analysis of the selected variables, also showing a well-adjusted model (p-value=0.198). The VIGF was defined as follows: VIGF=e^(8.1318-0.2941AbMax-0.0703FechGlo)/1+e^(8.1318-0.2941AbMax-0.0703FechGlo). Conclusion The VIGF demonstrated a cut-off value equal to 0.71. The probability of success was 81.5%, sensitivity 76.4%, and specificity 89.2%.