[Analysis of vocal fold movement and voice onset behavior in patients with laryngopharyngeal reflux based on high speed laryngeal high-speed videoendoscopy].

<b>Objective:</b>Patients with Laryngopharyngeal Reflux（LPR） have chronic inflammation of the laryngeal mucosa leading to a high response state in the larynx, which may make the vocal fold movement too fast. This paper discusses the characteristics of vocal fold movement and voice onset by analyzing laryngeal high-speed videoendoscopy in patients with LPR. <b>Methods:</b>Forty patients with LPR were enrolled as LPR group. The diagnostic criteria of LPR included positive reflux symptom index（RSI） and reflux syndrome score（RFS） to identify suspected LPR, objective oropharyngeal DX pH monitoring was carried out, and positive Ryan index indicated reflux. According to age and sex matching, 40 healthy volunteers were selected as the normal group. Laryngeal high-speed videoendoscopy, and the vocal fold motion and vibration parameters, including vocal fold adduction time, vocal fold abduction time, vocal fold vibration onset mode（vocal onset time and mode） and the opening quotient of vocal fold vibration cycle. Statistical analysis was performed using SPSS 25.0. <b>Results:</b>The time of vocal fold adduction in LPR group（mean 225.81ms） was less than that in normal group（mean 277.01 ms）, and the difference was statistically significant（<i>P</i><0.05）. There was no significant difference in adduction time between LPR group and normal group（<i>P</i>>0.05）. The vocal onset time in LPR group was significantly longer than that in normal group（<i>P</i><0.05）. High speed video endoscope showed that there were 17 patients with hard onset in LPR group and 8 patients with hard onset in normal group, the difference was statistically significant（<i>P</i><0.05）. There was no significant difference in the open quotient of vocal fold vibration between LPR group and normal group（<i>P</i>>0.05）. The vocal fold abduction time in LPR group（mean 372.92 ms） was less than that in normal group（mean 426.98ms）, but the difference was not statistically significant（<i>P</i>>0.05）. The time difference of bilateral abduction of vocal fold in LPR group was significantly higher than that in normal group（<i>P</i><0.05）. <b>Conclusion:</b>The larynx of LPR patients is in a high response state, the vocal fold moves faster, and it is more likely to have a hard vocal onset. These may result in voice dysfunction.