Avaliação anatomofuncional das lesões benignas da laringe por meio da videolaringoscopia digital de alta velocidade

Abstract

Introduction: Objective measures of vocal fold vibration were introduced in laryngology through high-speed videolaryngoscopy, which allows the visualization of the true periods of vocal fold vibration in phonation. Considered a powerful new instrument for investigating vocal fold dynamics, it provides essential information for clinical diagnosis in an effective, visual and quantitative way. It is able to detect small dynamic asymmetries between the vocal folds; differences in the glottic opening coefficient; lateral propagation of the mucosal waves and movements of the upper margin of the free edge of the vocal fold. The results of high speed videolaryngoscopy may allow the differential diagnosis of benign changes, as yet little studied, such as nodules and cysts, prevalent in the laryngological clinic. Objective: To analyze and compare vocal fold vibration pattern and the characteristics of women with vocal fold cysts and nodules using high speed videolaryngoscopy. Method: This is a cross-sectional clinical study, carried out in the city of Belo Horizonte - MG. Participants will be recruited at the otolaryngology clinic of a private clinic. A total of 60 subjects were selected, with ages varying between 18 and 45 years old, being the criterion of inclusion the otorhinolaryngological diagnosis by videolaryngoscopy of the nodule or cyst in vocal folds. Three study groups were composed of 20 women without laryngeal changes forming the control group 1, 20 women with diagnosis of vocal nodules forming Group 2 and 20 women with diagnosis of vocal fold cyst forming Group 3. Subsequently, they were referred for high-speed videolaryngoscopy for analysis and comparison of laryngeal images using kymography and glottal area parameters, using specific software. Results: in the analysis of the glottal area a greater minimum opening was found in the midpoint of the glottis in patients with cysts corroborating with the higher stiffness found in the vocal fold cover with these changes, which may lead to a greater minimum area and smaller values at maximum aperture in the point of the glottis of these individuals. With videokymography, it was possible to analyze the maximum and mean opening and amplitude of vocal folds in which patients with laryngeal lesions presented lower values than those found in vocal folds without alterations. In the comparison between the lesions, the cysts presented lower values of the mean opening than the nodules, and it can be inferred that this changes presents a greater rigidity in the mucosal wave. Although there was no statistical difference in relation to the cysts amplitude when compared to the nodules, they had higher values. Research with larger samples could show a statistical difference. Conclusion: Analysis of the parameters of high-speed digital videolaryngoscopy shows that vocal fold nodules and cysts increase glottic areas and decrease the vocal fold opening amplitude.