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https://codas.org.br/article/doi/10.1590/2317-1782/20212021214en
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Videokymographic index of glottic function: an analysis of diagnostic accuracy

Índice videoquimográfico da função glótica: análise da precisão diagnóstica

Alice Braga de Deus; Roberto da Costa Quinino; Marco Aurélio Rocha Santos; Ana Cristina Côrtes Gama

http://dx.doi.org/10.1590/2317-1782/20212021214en CoDAS, vol.35, n1, e20210214, 2023
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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%.

Keywords

Kymography; Voice; Dysphonia; Diagnostic Test Approval; Larynx

Resumo

Objetivo

Elaborar um indicador composto denominado Índice Videoquimográfico da Função Glótica – IVFG, a partir de parâmetros da videoquimografia digital, captados pelo exame de videolaringoscopia de alta velocidade de mulheres sem e com alterações laríngeas de etiologia comportamental.

Método

A amostra foi composta por 92 mulheres, destas 55 apresentaram disfonia comportamental, com presença de alterações laríngeas e vocais, e 37 mulheres sem alterações laríngeas e vocais, entre 18 a 45 anos. A avaliação vocal foi realizada por consenso pela análise perceptivo-auditiva da vogal /a/ em frequência e intensidade habituais, e classificação através do grau geral da disfonia, onde G0 indicou qualidade vocal neutra e G1 a 3 qualidade vocal alterada. As imagens laríngeas foram obtidas pela gravação da emissão da vogal /i/, em frequência e intensidade habituais para análise da videoquimografia digital. A construção do IVFG se deu pela escolha do ponto médio da glote para análise e, elaboração foi realizada regressão logística pelo programa MINITAB 19.

Resultados

A regressão logística contou com duas etapas, sendo que a etapa 1 constou da análise de todas as variáveis, onde as variáveis abertura máxima e fechamento glótico apresentaram significância estatística (p-valor <0.05) e o modelo se encontrou bem ajustado de acordo com o teste de Hosmer-Lemeshow (p-valor=0,794); na etapa 2, as variáveis selecionadas foram novamente analisadas e o modelo também se mostrou bem ajustado (p-valor=0,198). O IVFG foi definido por IVFG=e^(8,1318-0,2941AbMax-0,0703FechGlo)/1+e^(8,1318-0,2941AbMax-0,0703FechGlo).

Conclusão

O IVFG apresenta valor de corte igual a 0,71. A probabilidade de acerto é de 81,5%, sensibilidade 76,4%, especificidade de 89,2%.

Palavras-chave

Quimografia; Voz; Disfonia; Aprovação de Teste de Diagnóstico; Laringe

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