Functional evaluation of laryngoscopic examination and its relation to voice quality and voice range profile parameters

Summary Introduction: Previous laryngoscopy evaluation protocols have mostly focused on assessment of glottal status and morphological description of vocal folds’ shape and oscillations. The basic functional manifestations of laryngeal use, according to new protocols, include a description of supraglottic laryngeal activity. Methods: Laryngoscopic evaluation was performed as a perceptual test, performed online, using a web-based application. The degree and type of glottal insufficiency and the degree of anterior, posterior compression and lateral-medial (L-M) compression separately for each side were evaluated by a total of 15 respondents in a total of 26 video recordings of laryngoscopic examinations. In addition, the correlations between listening evaluations of the voice using modified GRBAS scales and voice range profile parameters were investigated. Results: The ratings of the laryngoscopic scales had well to excellent agreement. Agreement for type of insufficiency was just moderate. The associated ratings of L-M compression on the right and left sides showed correlations. For listening evaluation, medial compression was found to be related to the perception of habitual voice strain, and to strain and instability in the pitch range of the change of registers of the singing voice. Degree of insufficiency predicted less fullness of habitual voice in general but was also related to vocal dyspnea and weakness when calling. At the same time, it was largely responsible for the deterioration of the quality of the singing voice. Medial compression systematically reduced pitch range and the area of the voice range profile. Conclusion: The results of the perceptual evaluation can be used in further education. On their basis, didactic material for training the assessment of supraglottic laryngeal activity was prepared and published in the form of an online tutorial. The degree of insufficiency generally affects various characteristics of the speaking and singing voice. Medial compression systematically affects only the strain of the speaking voice, while in the singing voice it accentuates the strain and instability of the transitional region between registers and impairs the production of high pitches. Key words laryngoscopy – visual evaluation – voice range profile – GRBAS