Bargar Isabelle, Ippers Melina Maria, Neumann Katrin, Mathmann Philipp, Barsties V Latoszek Ben
School of Health, Education and Social Sciences, SRH University of Applied Sciences Heidelberg, 40210 Düsseldorf, Germany.
Department of Phoniatrics and Pediatric Audiology, University Hospital Münster, 48149 Münster, Germany.
J Clin Med. 2025 Sep 6;14(17):6309. doi: 10.3390/jcm14176309.
: Voice disorders caused by laryngeal hypertension can impact volume, quality, pitch, resonance, flexibility, and stamina. The laryngeal palpation is a tactile-perceptual assessment, which is one of a few examination methods to evaluate laryngeal hypertension. Laryngeal palpation is a manual examination of the extrinsic and paralaryngeal tissues of the larynx (e.g., lateral laryngeal mobility, thyrohyoid and cricothyroid spaces, vertical laryngeal position/mobility, and pain) through the examiner's fingers. It can be performed during rest (static assessment) or during phonation (dynamic assessment) of the individual being evaluated. This study aimed to validate a novel laryngeal palpation tool with quantitative ordinal scores by assessing its reliability and diagnostic accuracy establishing preliminary clinical cut-off values, and examining its correlations with self-reported voice disorder symptoms. : In a prospective, controlled validation study, 33 participants were selected to assess the validity and reliability of the novel diagnostic tool in a clinical sample and healthy controls. The clinical sample ( = 19) comprised individuals diagnosed with voice disorders, whereas the healthy control group ( = 14) included participants with no history or symptoms of voice pathology. The novel laryngeal palpation tool was employed by two independent examiners to assess both static and dynamic laryngeal function in all participants. In addition, each participant completed the following questionnaires: Voice Handicap Index (VHI-30) with the 30-item, Vocal Fatigue Index (VFI), and the Vocal Tract Discomfort Scale (VTD). : Static palpatory assessment of laryngeal tension demonstrated excellent discriminatory power between groups and tension levels (AROC = 0.979), along with high intra-rater (ICC = 0.966) and inter-rater reliability (ICC = 0.866). Significant correlations were revealed between the static palpation results and the VHI scores (r = 0.496; < 0.01) and VFI (r = 0.514; < 0.01). For the dynamic evaluation of the palpation tool, comparable results for the validity (AROC = 0.840) and reliability (inter-rater: ICC = 0.800, and intra-rater: ICC = 0.840) were revealed. However, no significant correlations were found between dynamic palpation and self-perceived questionnaires, although some were likely found with static palpation. The validity of the total score was found to be AROC = 0.992. : The static and dynamic assessments using the novel laryngeal palpation tool demonstrated promising reliability and diagnostic accuracy, providing initial evidence to support its clinical utility. Further studies are needed to establish broader validation.
喉内压升高引起的嗓音障碍会影响音量、音质、音高、共鸣、灵活性和耐力。喉部触诊是一种触觉感知评估，是评估喉内压升高的少数检查方法之一。喉部触诊是通过检查者的手指对喉部的外在和喉旁组织进行手动检查（例如，喉侧向活动度、甲状舌骨和环甲间隙、喉垂直位置/活动度以及疼痛情况）。它可以在被评估个体休息时（静态评估）或发声时（动态评估）进行。本研究旨在通过评估一种新型喉部触诊工具的可靠性和诊断准确性、建立初步临床截断值并检查其与自我报告的嗓音障碍症状的相关性，来验证该工具具有定量有序评分的有效性。
在一项前瞻性对照验证研究中，选取了33名参与者，以评估这种新型诊断工具在临床样本和健康对照中的有效性和可靠性。临床样本（n = 19）包括被诊断患有嗓音障碍的个体，而健康对照组（n = 14）包括没有嗓音病理学病史或症状的参与者。两名独立的检查者使用这种新型喉部触诊工具对所有参与者的静态和动态喉部功能进行评估。此外，每位参与者还完成了以下问卷：30项的嗓音障碍指数（VHI - 30）、嗓音疲劳指数（VFI）和声道不适量表（VTD）。
喉部张力的静态触诊评估在组间和张力水平之间显示出出色的区分能力（曲线下面积 = 0.979），同时具有较高的检查者内信度（组内相关系数 = 0.966）和检查者间信度（组内相关系数 = 0.866）。静态触诊结果与VHI评分（r = 0.496；P < 0.01）和VFI（r = 0.514；P < 0.01）之间存在显著相关性。对于触诊工具的动态评估，在有效性（曲线下面积 = 0.840）和可靠性方面（检查者间：组内相关系数 = 0.800，检查者内：组内相关系数 = 0.840）得到了可比的结果。然而，动态触诊与自我感知问卷之间未发现显著相关性，尽管静态触诊可能发现了一些相关性。总分的有效性被发现曲线下面积为0.992。
使用这种新型喉部触诊工具进行的静态和动态评估显示出有前景的可靠性和诊断准确性，为支持其临床实用性提供了初步证据。需要进一步的研究来建立更广泛的验证。
