BACKGROUND AND OBJECTIVES: High-speed videolaryngoscopy (HSV) is the only technique that captures the true intra-cycle vibratory behavior of the vocal folds by capturing full images of the vocal folds. However, it has problems of no immediate feedback during examination, considerable waiting time for digital kymography (DKG), recording duration limited to a few seconds, and extreme demands for storage space. Herein, we demonstrate a new post-processing method that converts HSV images to two-dimensional digital kymography (2D-DKG) images, which adopts the algorithm of 2D videokymography (2D VKG). MATERIALS AND METHODS: HSV system was used to capture images of vocal folds. HSV images were post-processed in Kay image-process software (KIPS), and conventional DKG images were retrieved. Custom-made post-processing system was used to convert HSV images to 2D-DKG images. The quantitative parameters of the post-processed 2D-DKG images was validated by comparing these parameters with those of the DKG images. RESULTS: Serial HSV images for all phases of vocal fold vibratory movement are included. The images were converted by the scanning method using U-medical image-process software. Similar to conventional DKG, post-processed 2D DKG image from the HSV image can provide quantitative information on vocal fold mucosa vibration, including the various vibratory phases. Differences in amplitude symmetry index, phase symmetry index, open quotient, and close quotient between 2D-DKG and DKG were analyzed. There were no statistical differences between the quantitative parameters of vocal fold vibratory movement in 2D-DKG and DKG. CONCLUSION: The post-processing method of converting HSV images to 2D DKG images could provide clinical information and storage economy.
Kymography ; Methods ; Mucous Membrane ; Vibration ; Vocal Cords ; Voice

BACKGROUND AND OBJECTIVES: Voice quality is determined by the vibration of the vocal cord. Therefore, visualization of the vibratory characteristics of the vocal cord is very important in patients with voice changes. Several methods for directly visualizing the vibrations of the vocal cord have been developed, although none have been commercially available or widely used. Recently, videokymography (VKG) has been developed for direct observation of vibratory characteristics in the vocal cord. VKG achieves a frequency of 7812.5 Hz, which is enough to cover the whole frequency range of the human vocal cord. However, there have been no useful parameters for interpretation of the VKG findings. MATERIALS AND METHODS: We evaluated the vocal cord vibration of 92 subjects (23 of normal, 69 of benign laryngeal lesion) and suggested 9 parameters. We analyzed VKG recordings of subjects using these parameters and interpreted the typical and common VKG findings in each case. RESULTS: There were typical differences in glottal contact, site of glottal contact, shape of glottal contact, mucosal wave, periodicity and symmetry between two groups. Amplitude of upper lip and contact quotient had a highly significant correlation between them. CONCLUSIONS: The authors suggest that these parameters would be useful to quantify the VKG findings.
Humans ; Kymography ; Lip ; Periodicity ; Vibration ; Vocal Cords ; Voice ; Voice Quality

BACKGROUND AND OBJECTIVES: Evaluation of facial movements, especially eyelid movements, per se, depends largely on subjective judgments of trained clinicians. Recently, however, a few objective methods were reported although they required bothersome markers attached on the eyelids and a special-purpose high-speed video camera. This study aimed to develop a new dynamic and quantitative analysis system for eyelid motion using an image processing method without markers or a high-speed camera, and to evaluate parameters that could properly differentiate normal and abnormal states. MATERIALS AND METHOD: The system was consisted of a personal computer with a general-purpose frame grabber and a specially developed software which was named, Blepharokymography. Displacement of upper eyelids, duration of closing and opening segments, and closing and opening velocity were measured in 12 normal subjects and 5 facial nerve palsy patients of variable causes. Mean values of each parameter and the ratio of a palsy or slower side to a normal or faster side in normal and facial palsy groups were compared. RESULTS: In the normal group, the mean displacement of upper eyelids, mean closing time, mean and peak closing velocity were 8.3mm, 161 msec. 61.6 mm/sec and 146.2 mm/sec respectively. Among parameters, displacement, the closing time, mean closing velocity and peak closing velocity were significantly different between normal and facial palsy groups. CONCLUSION: By using blepharokymography system, it was possible to measure the eyelid motion objectively. Displacement, closing time, average and peak closing velocity were useful in differentiating the normal state as well as the facial nerve palsy state.
Eyelids* ; Facial Nerve ; Facial Paralysis ; Humans ; Judgment ; Kymography ; Microcomputers ; Paralysis

BACKGROUND AND OBJECTIVES: Non-organic voice disorders are very difficult to diagnose. The authors attempted to find out the efficiency of videokymography (VKG) which has been newly developed to evaluate the vibratory characteristics of the vocal folds in non-organic voice disorders. MATERIALS AND METHODS: Eighty-seven patients who had voice changes without organic laryngeal pathology were evaluated. We ascertained the larynx to be free of organic disorders using the stroboscopy, following which the VKG examination was performed. The results of VKG were classified according to the common features. RESULTS: Type I showed the normal findings. Asymmetry in the amplitude of upper lips was seen in the type II. Type III showed thick glottal contact. Type IV showed level difference, thick glottal contact and asymmetry in the amplitude of upper lips. Type V had several different amplitudes of the upper lip seen in one cycle of the mucosal wave. Type VI had level difference with thin glottal contact and asymmetry in the amplitude of upper. CONCLUSIONS: Based on these results, we were able to see the different types of VKG and that VKG could be used as a supplementary diagnostic tool in the non-organic voice disorders.
Humans ; Kymography ; Larynx ; Lip ; Pathology ; Stroboscopy ; Vocal Cords ; Voice Disorders* ; Voice*