High-speed video or video stroboscopy in adolescents: which sheds more light?

The primary objective of this study was to compare the utility of high-speed video (HSV) to videostroboscopy (VS) in the assessment of adolescents with normal and abnormal larynges. A secondary objective was to evaluate the ease of assessment of adolescents with HSV.

Case series with chart review.

Tertiary academic health care center.

This study involved a retrospective review of recordings of 7 adolescents assessed with both HSV and VS. The 14 recordings were randomized and presented to 4 groups of blinded evaluators: 2 fellowship-trained laryngologists, 2 speech language pathologists (SLP) with multiyear experience working in a voice clinic, 2 pediatric otolaryngologists, and 2 otolaryngology residents. Raters were asked to evaluate the videos using a standardized scoring tool. Raters also completed a questionnaire assessing their opinion of the HSV and VS recordings.

Evaluators required more time to complete their assessment of VS recordings (2.95 min ± 2.41 min) than HSV recordings (2.31 min ± 1.92 min) (P = .004). There was no difference in ease of evaluation (P = .878) or diagnostic accuracy within evaluator groups by recording modality (P = .5). The overall agreement between VS and HSV was moderate (kappa [SE] = 0.446 [0.029]). The debrief questionnaire revealed that 5 of 8 (62.5%) preferred VS to HSV.

This is the first comparative study between HSV and VS in patients under 18 years of age. HSV permitted faster evaluation than VS, but there was no difference in diagnostic accuracy between the 2 modalities. The evaluators preferred VS to HSV.