Effect of Nebulization on Laryngeal Parameters: Analysis Using High-Speed Digital Videolaryngoscopy

Elisa Meiti Ribeiro Lin Plec; Ana Cristina Côrtes Gama; Bárbara Oliveira Souza; Marco Aurélio Rocha Santos

doi:10.1016/j.jvoice.2022.01.014

Effect of Nebulization on Laryngeal Parameters: Analysis Using High-Speed Digital Videolaryngoscopy

J Voice. 2022 Mar 11:S0892-1997(22)00014-5. doi: 10.1016/j.jvoice.2022.01.014. Online ahead of print.

Authors

Elisa Meiti Ribeiro Lin Plec¹, Ana Cristina Côrtes Gama², Bárbara Oliveira Souza³, Marco Aurélio Rocha Santos⁴

Affiliations

¹ Department of the Faculdade de Medicina - Universidade Federal de Minas Gerais - UFMG. Av. Alfredo Balena, Otolaryngologist of the Hospital Felício Rocho Belo Horizonte, Belo Horizonte Minas Gerais, Brasil. Electronic address: elisaplecotorrino@gmail.com.
² Universidade Federal de Minas Gerais - Postgraduate program of the Speech and Language Department of the Faculdade de Medicina - Universidade Federal de Minas Gerais - UFMG. Av. Alfredo Balena, Belo Horizonte Minas Gerais, Brasil.
³ Department of the Faculdade de Medicina - Universidade Federal de Minas Gerais - UFMG. Av. Alfredo Balena, Belo Horizonte Minas Gerais, Brasil.
⁴ Department of the Faculdade de Medicina - Universidade Federal de Minas Gerais - UFMG. Av. Alfredo Balena, Professor of the Universidade Federal de Minas Gerais - Otolaryngologist of the Hospital Felício Rocho - Belo Horizonte, Belo Horizonte Minas Gerais, Brasil.

PMID: 35288013
DOI: 10.1016/j.jvoice.2022.01.014

Abstract

Introduction: Superficial laryngeal hydration, obtained through nebulization, is related to the moisture level on the epithelial surfaces of the vocal folds, modifying their biomechanical and aerodynamic properties. Through high-speed videolaryngoscopy it is possible to obtain objective data for laryngeal analysis after nebulization and a better understanding of this phenomenon OBJECTIVE: To verify the effects of nebulization with saline solution on laryngeal parameters of digital videokymography obtained by high-speed videolaryngoscopy examination in women and men with and without laryngeal alterations METHOD: This is a clinical, comparative intra-subject study. Fifty-nine adults were selected, with and without laryngeal alterations, 30 females and 29 males. Digital videokymographs in the anterior, middle and posterior thirds of the vocal folds of the participants were analyzed before and after nebulization with 0.9% saline solution.

Results: Women without laryngeal alterations showed more parameters changes after nebulization, in which there was a decrease in maximum and medium opening, amplitude of opening of the left and right vocal fold in the anterior glottal third, and an increase of the percentage of closure of the vocal folds. These results indicate a minor extent of lateral excursion of the vocal folds during phonation. In women with laryngeal alterations, the parameters that changed after nebulization were the increased frequency of opening of the left and right vocal folds in the topography of the posterior third. In men, nebulization did not change the variables studied, except for the amplitude of the right vocal fold in men with laryngeal alterations, in the analysis of the posterior glottic third.

Conclusion: The results suggest that surface hydration modifies laryngeal dynamics differently between genders. After nebulization with saline solution, women without laryngeal alterations showed a decrease in the lateralization of the vocal folds during phonation, suggesting a better phonatory efficiency.

Keywords: Dysphonia; Hydration; Kymography; Larynx; Vocal fold.