A Multimodal Approach for Deep‐Learning Classification of Vocal Fold Pathologies in Stroboscopy

ABSTRACT Objective To develop and validate a multimodal deep‐learning classifier trained on stroboscopic image, voice, and clinicodemographic data, differentiating between three different vocal fold (VF) states: healthy (HVF), unilateral paralysis (UVFP), and VF lesions, including benign and malignant pathologies. Methods Patients with UVFP ( n = 54), VF lesions ( n = 42), and HVF ( n = 41) were retrospectively identified. Image frames and voice samples were extracted from stroboscopic videos. Clinicodemographic variables were collected from the electronic health record. Patient‐level data was independently divided into training (80%) and testing (20%). Visual features were extracted using a transformer DINOv2 and acoustic features were extracted using Librosa. All three feature modalities were combined using a custom multilayer perceptron. Unimodality models using only image or only voice data were trained for comparison. Accuracy and F 1 scores were used to validate the models. Results On a hold‐out test set, the multimodal classifier demonstrated stronger performance (76.9% accuracy) compared to the image classifier (61.5% accuracy) and audio classifier (65.4% accuracy). On an external dataset, the multimodal classifier accuracy dropped to 45%, though still an improvement compared to accuracies of 42% and 31% for the video‐only and audio‐only modalities, respectively. Conclusions In this proof‐of‐concept study, we successfully developed a multimodal dataset and classifier for VF pathology, demonstrating the potential of combining stroboscopic frames, voice and text data. The multimodal classifier achieved higher accuracy than the image‐only model and audio‐only models. Future models should validate these findings on larger datasets. Level of Evidence 4