Comparative Evaluation of High-Speed Videoendoscopy and Laryngovideostroboscopy for Functional Laryngeal Assessment in Clinical Practice

Advancements in dynamic laryngeal imaging, particularly high-speed videoendoscopy (HSV), have addressed several limitations of laryngovideostroboscopy (LVS). This study aimed to compare the success rates of LVS and HSV in generating recordings suitable for objective functional assessment of vocal fold movements. <b>Methods:</b> This study included 200 patients with voice disorders (123 with benign glottal lesions, 56 with malignant lesions, and 21 with functional voice disorders) and 47 normophonic individuals. All participants underwent LVS followed by HSV. Kymographic analysis was performed to evaluate phonatory parameters, including amplitude, symmetry, and glottal dynamics. The success of both methods in generating analyzable kymograms was assessed, and statistical comparisons were made using the chi-square test (significance level set at <i>p</i> < 0.05). <b>Results</b>: The failure rate for LVS was significantly higher (43.32%) compared to HSV. HSV successfully generated kymograms in 68.22% of cases where LVS failed. The primary factors contributing to LVS failure included synchronization issues, inadequate recording brightness, unstable phonation, and hidden glottal opening. Failure rates related to structural obstacles were similar between the two methods. HSV demonstrated superior kymogram feasibility across all subgroups, with the highest success observed in cases of organic glottal pathologies (30.73%). A significant advantage of HSV was observed for both benign and malignant glottal lesions, especially in cases of asynchronous vocal fold oscillations. <b>Conclusions</b>. By overcoming the inherent limitations of LVS, HSV provides a more reliable and objective assessment of phonatory function. Its ability to generate suitable kymograms with greater precision makes HSV a valuable tool for routine clinical diagnostics, enabling the accurate identification of subtle laryngeal pathologies and enhancing diagnostic accuracy.