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Correlation of Glottic Gap and Voice Impairment in Presbyphonia
Author(s) -
McGarey Patrick O.,
Bitar Ryan,
Hughes Charlotte K.,
Hodson Noah,
Harris Edward A.,
Dominguez Laura M.,
Dion Gregory R,
Simpson C. Blake
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29068
Subject(s) - medicine , phonation , intraclass correlation , wilcoxon signed rank test , larynx , glottis , stroboscope , audiology , voice disorder , cohort , retrospective cohort study , mann–whitney u test , surgery , psychometrics , clinical psychology , engineering , electrical engineering
Objective/Hypothesis The objective of this study was to investigate the glottic gap area as a significant marker for the severity of presbyphonia as it relates to patient‐reported outcome measures (Voice Handicap Index‐10 [VHI‐10]) and stroboscopic findings. Study Design Retrospective case‐control study conducted in an academic tertiary voice center. Methods Patients seen at a tertiary voice clinic who were diagnosed with presbyphonia without other organic laryngeal pathology from January 2014 to December 2017 were included. Clinical data and laryngeal videostroboscopy videos were collected. Still images at the point of vocal process approximation during adduction were captured, and the glottic gap area was measured using ImageJ. These were compared to a control cohort. Correlations were made using Wilcoxon rank sum test, Mann–Whitney U test, and Pearson correlation coefficients. Results Thirty‐three patients were included. Inter‐rater reliability of glottic area measurement was strong (intraclass correlation coefficient = 0.73, P < .001). Compared to controls, presbyphonia patients had a larger glottic gap area ( P < .001) and greater open‐phase quotient on laryngeal videostroboscopy ( P < .001). Larger glottic gap area did not correlate with patient‐reported vocal function as measured by VHI‐10 ( P = .79) and did not correlate with presence of secondary muscle tension dysphonia ( P = .99). In the presbyphonia cohort, the glottic gap area did not correlate with age ( P = .29). Conclusions Glottic gap area at the point of vocal process approximation during phonation can be reliably measured. Patients with presbyphonia have a larger glottic gap area and greater open‐phase quotient on stroboscopy, but these do not correlate with patient‐reported voice impairment or the presence of secondary muscle tension dysphonia (MTD). These data suggest that dysphonia severity in presbyphonia is not fully explained by a glottic gap or secondary MTD alone. Level of Evidence 4 Laryngoscope , 131:1594–1598, 2021