Medical Student Keck School of Medicine, USC Seattle, Washington
Objective: Vocal fold atrophy (VFA) is a stroboscopic diagnosis associated with aging and Parkinson’s Disease (PD). The purpose of this study was to use objective measures of VFA to; 1) Examine the relationship between dysphonia severity and VFA, 2) Evaluate differences in VFA between patients with PD and age-related VFA.
Methods: Thirty-one patients >60 years of age with VFA were included in this retrospective cohort study. Demographics, medical history, dysphonia severity ratings using CAPE-V, and still images from stroboscopy were obtained. Patients were stratified into three groups; mild dysphonia (CAPE-V <30 [N=15]), severe dysphonia (CAPE-V>30 [N=7]), and PD (any CAPE-V [N=8]). Image JTM was used by two independent reviewers to measure bowing index (BI), glottal gap and mucosal wave amplitude (NMWA). Measurements were normalized to vocal fold length (VFL) and reported as percent VFL.
Results: The average CAPE-V was 15.8(±6.6) in mild dysphonia, 42(±7.5) in severe dysphonia, and 41.3(±14.5) in PD. The average BI in severe dysphonia was 11.1(±3.9), comparable to in PD (10.7[±2.8]), both of which were significantly larger than in mild dysphonia (5.8; 95%CI 2.0, 9.0 and 5.0; 95%CI -1.7, 8.4, respectively). Glottal gap in severe dysphonia was 2.4(±2.4), significantly larger than in both mild dysphonia (2.1; 95%CI 0.53, 3.7) and PD (2.0; 95%CI 0.2, 3.7). NMWA did not differ between groups.
Conclusion:Patients with more severe dysphonia had larger bowing index and glottal gap. Patients with PD had similar bowing index to those with severe age-related VFA but maintained glottal closure. the post-operative F0. In addition, there was improved satisfaction in vocal character after the procedure.