DiagNova | Papers

Clinical Applications & Publications

Imaging systems by DiagNova Technologies — including the high-speed camera ALI-Cam-HS1, the light source ALI-LUM-MF1, , and the software DiagnoScope Specialist — have been supporting scientific research in otolaryngology, phoniatrics, and phonosurgery for many years. Our technologies have been featured in numerous publications dedicated to the assessment of phonatory function, dysphonia diagnostics, and the analysis of vocal fold biomechanics.

Below we present a selection of scientific papers that utilized DiagNova equipment.
If your publication is not on the list, you can submit it via the form at the bottom of the page — just provide the basic details (authors, title, journal, year, DOI). You may also upload a summary of your paper — and if you don’t have one, we will gladly prepare it for you based on the provided information.

If you are interested in starting scientific research using our equipment or need support in data analysis, our team will be happy to assist you. We can also help you correctly affiliate DiagNova systems in your publication and ensure proper citation.

Please refer to our products as follows:

ALIS system consisting of: ALI Cam-HS1 – high-speed camera and ALI Lum-MF1 – endoscope laser light source (DiagNova Technologies, Wrocław, Poland)
DiagnoScope Specialist Software (DiagNova Technologies, Wrocław, Poland)

Feel free to contact us for collaboration opportunities.

High-Speed Videoendoscopy and Stiffness Mapping for AI-Assisted Glottic Lesion Differentiation

Magdalena M. Pietrzak , Justyna Kałuża-Olszewska , Ewa Niebudek-Bogusz , Artur Klepaczko , Wioletta Pietruszewska
Cancers (Basel), 2025, 17(8):1376
DOI: 10.3390/cancers17081376 • full text

Study overview:
This study investigated the diagnostic utility of stiffness mapping and the Stiffness Asymmetry Index (SAI) derived from laryngeal high-speed videoendoscopy (HSV) recordings for distinguishing benign from malignant glottic lesions. The study included 102 patients with various vocal fold pathologies, including confirmed laryngeal cancers. The analysis focused on non-standard biomechanical vibration parameters related to stiffness and motion symmetry.

Findings:
SAI (AUC = 0.91; 95% CI: 0.839–0.962) and amplitude asymmetry (AUC = 0.92; 95% CI: 0.85–0.974) effectively differentiated healthy from pathological vocal folds. Machine learning classifiers, especially SVM, enhanced diagnostic performance—achieving AUC = 0.93 for organic lesion detection and AUC = 0.83 for malignancy discrimination. SAI-based models demonstrated high predictive power for cancer infiltration presence.

Conclusions:
Stiffness-based biomechanical markers extracted from HSV provide a promising, non-invasive strategy for early detection of glottic cancer. Combining vibratory signal analysis with AI techniques offers strong potential to improve differential diagnostics without requiring immediate biopsy.

Significance of the DiagNova system:
The study used a laryngeal high-speed videoendoscopy system built on the Diagnova ALI-Cam-HS1 camera and DiagnoScope Specialist software. The system enabled accurate acquisition of biomechanical motion data and facilitated AI-based classification through proprietary imaging algorithms. This represents another example of applying DiagNova’s system in cutting-edge research at the interface of laryngology and artificial intelligence.

Objective and Subjective Voice Outcomes in Post-COVID-19 Dysphonia: A High-Speed Videoendoscopy Pre–Post Study

Joanna Jeleniewska , Jakub Malinowski , Ewa Niebudek-Bogusz , Wioletta Pietruszewska
Journal of Clinical Medicine, 2025, 14(19):6861
DOI: 10.3390/jcm14196861 • full text

Study overview:
This study assessed the effectiveness of voice rehabilitation in patients with isolated post-COVID-19 dysphonia using both objective biomechanical data from high-speed videoendoscopy (HSV) and subjective perceptual assessments. Fourteen patients with persistent dysphonia (mean duration: 4.5 months) underwent HSV-based and subjective evaluations before and after a one-month voice therapy program.

Findings:

Significant improvements were noted in objective HSV parameters such as vibratory amplitude, symmetry, and regularity.
Subjective measures (VHI-30 and GRBAS) also improved following therapy.
HSV parameters strongly correlated with perceived voice improvement (r > 0.6, p < 0.01).
Amplitude, phase difference, and vibratory irregularity were sensitive to treatment effects.

Conclusions:
High-speed videoendoscopy offers valuable objective insight into the therapeutic effects in post-COVID-19 dysphonia. Specific HSV metrics may serve as reliable indicators of treatment response.

Significance of the DiagNova system:
The study utilized the DiagNova ALI-Cam-HS1 system and DiagnoScope Specialist software for detailed biomechanical analysis. This technology proved effective for monitoring therapy outcomes and objectively tracking voice recovery in challenging post-COVID dysphonia cases.

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

Joanna Hoffman , Magda Barańska , Ewa Niebudek-Bogusz , Wioletta Pietruszewska
Journal of Clinical Medicine, 2025, 14(5):1723
DOI: 10.3390/jcm14051723 • full text

Study overview:
This study compared the clinical utility of high-speed videoendoscopy (HSV) and laryngovideostroboscopy (LVS) in routine laryngeal function assessment. A total of 247 individuals—including patients with voice disorders and normophonic subjects—underwent both HSV and LVS. The study focused on data completeness and the feasibility of extracting objective biomechanical parameters.

Findings:

The failure rate for LVS was significantly higher (43.32%) compared to HSV. The main factors contributing to LVS failures were synchronization issues, insufficient recording brightness, unstable phonation, and hidden glottal openings.
HSV enabled the generation of kymograms in 68.22% of cases where LVS failed to provide usable data.
HSV demonstrated better kymogram feasibility across all subgroups, with the highest success observed in cases of organic glottic pathology (30.73%).
A marked advantage of HSV was observed in both benign and malignant glottic lesions, particularly in cases with asynchronous vocal fold oscillations.
HSV enabled the generation of kymograms in 68.22% of cases where LVS failed to provide usable data.
HSV proved especially valuable in patients with unstable phonation, organic lesions, and aphonia.
The Diagnoscope software allowed the extraction of biomechanical parameters (amplitude, asymmetry, vibration irregularity) even in cases where stroboscopic assessment was not feasible.

Conclusions:
HSV, particularly when supported by kymographic and vibratory parameter analysis, outperforms LVS in complex clinical scenarios and enhances diagnostic objectivity in phonatory assessment.

Significance of the DiagNova system:
The study utilized the DiagNova ALI-Cam-HS1 high-speed videoendoscopy system and DiagnoScope Specialist software. With its high frame rate and full synchronization, the DiagNova platform proved superior to traditional LVS in generating analyzable data. It offers a strong candidate for future standardization in voice diagnostics.

Assessment of the Interdependencies Between High-Speed Videoendoscopy and Simultaneously Recorded Audio Data in Various Glottal Pathologies

Magdalena M. Pietrzak , Wioletta Pietruszewska , Magda Barańska , Aleksander Rycerz , Konrad Stawiski
Biomedicines, 2025, 13(2):511
DOI: 10.3390/biomedicines13020511 • full text

Study overview:
This study investigated the relationships between kymographic parameters derived from high-speed videoendoscopy (HSV) and simultaneously recorded acoustic signals. The cohort included 192 participants classified as normophonic or presenting functional changes or organic lesions (benign, premalignant, and malignant). HSV-based kymography parameters were calculated for three glottal widths and compared with corresponding acoustic measures. Correlations were assessed and the impact of cycle-detection consistency was evaluated.

Findings:

The strongest agreement between HSV- and audio-derived measures was observed for F0 (0.97) and mean Jitter (Jita: 0.40–0.70).
When cycle detection was consistent between methods, correlations increased further (F0: 0.99; Jita: 0.68–0.98).
Other parameters showed low-to-moderate correlations, with no significant differences across most diagnostic subgroups (functional changes, benign and malignant lesions).
In the premalignant lesions subgroup, high correlations (0.77–0.90) were observed for measures describing period perturbations.
Beyond F0 and mean Jitter, cycle-detection consistency did not substantially affect correlation levels.

Conclusions:
Simultaneously recorded audio can support verification of HSV quantification, particularly for F0, which showed very strong agreement between methods. Lower correlations for other parameters may reflect the influence of supraglottic resonators (throat, mouth, nose) on the acoustic signal. While HSV-based kymography provides detailed descriptions of vocal fold oscillations, it does not fully capture the three-dimensional structure and complex functionality of the vocal folds.

Significance of the DiagNova systems:
The publication highlights the value of combining HSV-based kymography with simultaneously recorded audio to strengthen confidence in quantitative measures (especially F0 and period perturbation indices). Although the manufacturer of the HSV system was not specified in the paper, the presented workflow aligns with the capabilities of DiagNova solutions used for high-speed imaging and objective voice analysis in clinical and research settings.

Value of high-speed videoendoscopy as an auxiliary tool in differentiation of benign and malignant unilateral vocal lesions

Jakub Malinowski , Wioletta Pietruszewska , Magdalena Kowalczyk , Ewa Niebudek-Bogusz
Journal of Cancer Research and Clinical Oncology, 2024, 150(1):10
DOI: 10.1007/s00432-023-05543-y • full text

Study overview:
This study aimed to evaluate the usefulness of objective vibratory parameters derived from high-speed videoendoscopy (HSV) as a supportive tool in differentiating benign from malignant vocal fold lesions. A total of 175 participants were enrolled: 50 normophonic individuals, 85 with benign lesions, and 40 with early-stage glottic cancer. All organic lesions were histopathologically confirmed. Parameters extracted from HSV-based kymographic analysis included vibration amplitude, asymmetry, and dynamic glottal characteristics.

Findings:

Out of 14 analyzed parameters, 10 showed statistically significant differences between groups.
The most effective features for differentiating benign and malignant lesions were: average amplitude of the affected fold (AmpInvolvedAvg), amplitude asymmetry across the entire glottis and its middle third (AmplAsymAvg, AmplAsymAvg_2/3), and absolute average phase difference (AbsPhaseDiffAvgi).
Increased malignancy risk was associated with lower amplitude values and increased asymmetry and phase discrepancies.
The highest AUC was obtained for AmplAsymAvg (0.719), followed by AmpInvolvedAvg (0.70).

Conclusions:
While the gold standard in assessing vocal fold pathology remains clinical examination and histopathological confirmation, HSV offers relevant quantitative parameters that may assist in the early, non-invasive differentiation of benign and malignant vocal fold lesions.

Significance of the DiagNova systems:
The study employed the DiagNova ALI-Cam-HS1 high-speed videoendoscopy system together with DiagnoScope Specialist software, which enabled high temporal resolution imaging (3200 fps) and laser illumination. The DiagNova platform facilitated precise biomechanical evaluation of phonatory function and may serve as a valuable tool in oncologic diagnostics—especially in challenging cases requiring early lesion stratification prior to biopsy.

High-Speed Videoendoscopy Enhances the Objective Assessment of Glottic Organic Lesions: A Case-Control Study with Multivariable Data-Mining Model Development

Jakub Malinowski , Wioletta Pietruszewska , Konrad Stawiski , Magdalena Kowalczyk , Magda Barańska , Aleksander Rycerz, , Ewa Niebudek-Bogusz
Cancers (Basel), 2023, 15(14):3716
DOI: 10.3390/cancers15143716 • full text

Study overview:
This case-control study aimed to evaluate the diagnostic performance of high-speed videoendoscopy (HSV) combined with data-mining models for differentiating glottic organic lesions. It included 100 patients with unilateral benign vocal fold lesions (polyps, nodules, cysts) and 38 controls with healthy voices. Biomechanical parameters were extracted from HSV recordings using the DiagNova system and analyzed through multivariable models. All lesions were histopathologically confirmed.

Findings:
Multiple vibratory features (e.g., amplitude asymmetry index, periodicity irregularity index) showed statistically significant differences between pathological and healthy vocal folds.
Two data-mining models using support vector machine (SVM) and Boruta feature selection achieved the following performance:

For detection of organic lesions: AUC = 0.983; accuracy: 89.3%; sensitivity: 97.0%; specificity: 71.4%
For lesion type differentiation: AUC = 0.85; accuracy: 80.6%; sensitivity: 100%; specificity: 71.1%

The models were particularly effective in distinguishing polyps from nodules and pathological from healthy folds—showing promising clinical relevance.

Conclusions:
High-speed videoendoscopy, combined with biomechanical signal analysis and artificial intelligence, significantly enhances the objectivity of glottic lesion diagnostics. The derived features can support clinical decision-making and therapy monitoring in laryngology.

Significance of the DiagNova systems::
The study employed the DiagNova ALI-Cam-HS1 system and DiagnoScope Specialist software, which enabled high-resolution vibratory imaging and biomechanical parameter extraction. DiagNova’s HSV platform was crucial for generating objective, quantifiable voice indicators and integrating data-mining techniques into clinical workflows.

Isolated Severe Dysphonia as a Presentation of Post-COVID-19 Syndrome

Joanna Jeleniewska , Ewa Niebudek-Bogusz Jakub Malinowski , Joanna Morawska , Joanna Miłkowska-Dymanowska , Wioletta Pietruszewska ,
Diagnostics (Basel), 2022, 12(8):1839
DOI: 10.3390/diagnostics12081839 • full text

Study overview:
This study evaluated six patients (3.8% of 158 meeting WHO criteria for post-COVID-19 syndrome) who presented with severe isolated dysphonia as a potential symptom of long COVID. Each underwent comprehensive ENT examination, voice self-assessment, and instrumental diagnostics using laryngovideostroboscopy (LVS) and high-speed videoendoscopy (HSV).

Findings:

HSV findings before treatment revealed:

irregular and asymmetric vocal fold vibrations,
absence of mucosal wave,
incomplete glottal closure.

After treatment (systemic steroids, hyaluronic acid inhalation, reflux management), improvements were observed in:

vibratory symmetry and regularity in HSV,
kymography and glottal width waveform (GWW),
acoustic parameters: Jitter decreased from 3.16 to 2.97, Shimmer from 7.16 to 2.77,
patient-reported voice function.

Conclusions:
Isolated severe dysphonia may be a manifestation of post-COVID syndrome. HSV proved more sensitive than LVS in detecting subtle vibratory abnormalities, making it a valuable tool for diagnosing and tracking treatment outcomes in post-COVID voice disorders.

Significance of the DiagNova systems:
The study used the DiagNova ALI-Cam-HS1 high-speed camera, enabling detailed real-time recording of vocal fold vibrations. The system allowed detection of subtle phonatory dysfunctions undetectable with standard stroboscopy. DiagNova’s HSV technology supported by dedicated DiagnoScope Specialist software supports both clinical diagnosis and advanced voice research applications.

Segmentation of Glottal Images from High Speed Videoendoscopy Optimized by Synchronous Acoustic Recordings

Bartosz Kopczynski , Ewa Niebudek-Bogusz , Wioletta Pietruszewska , Pawel Strumillo
Sensors (Basel), 2022, 22(5):1751
DOI: 10.3390/s22051751 • full text

Study overview:
The authors proposed a fully automatic algorithm for segmenting the glottal gap in images obtained via high-speed videoendoscopy (HSV), using synchronously recorded audio signals to guide and optimize segmentation. The study included 22 participants: 11 with normophonic voices and 11 with dysphonia. The process involved: Converting HSV frames to grayscale and extracting the region of interest (glottal gap),

Applying multiple segmentation variants using α (median filter size) and β (binarization threshold),
Generating a glottovibrogram and computing its Fourier spectrum for each variant,
Comparing the spectrum with that of the synchronous acoustic recording,
Selecting the variant with the lowest spectral difference (cost function).

Findings:
The method enabled automatic segmentation without manual annotation. Key glottal parameters revealed significant differences between groups:

Healthy voices: OQ = 0.69, MRGA = 0.06
Dysphonic voices (glottal insufficiency): OQ = 1.0, MRGA = 0.35

Conclusions:
Synchronizing audio and high-speed video recordings enhances the accuracy of glottal segmentation, allowing for automated, expert-level voice analysis without subjective bias, although the authors note that further research on larger and more diverse patient groups is needed.

Significance of the DiagNova systems:
The study employed the DiagNova ALI-Cam-HS1, capturing images at high frame rate with full-color resolution. This high temporal resolution was essential for accurate synchronization with acoustic data and allowed for reliable vibratory pattern extraction. DiagNova’s system, including data analysis tool DiagnoScope Specialist software provided not just imaging but also a robust platform for computational voice diagnostics, reinforcing its value in both research and clinical settings.

Laryngeal High-Speed Videoendoscopy with Laser Illumination: A Preliminary Report

Jakub Malinowski , Ewa Niebudek-Bogusz , Marcin Just, Joanna Morawska , Anna Racino, Joanna Hoffman , Magda Barańska , Magdalena Marianna Kowalczyk , Wioletta Pietruszewska
Otolaryngologia Polska, 2021, 75(6):1–10
DOI: 10.5604/01.3001.0015.2575 • full text

Study overview:
This study presents the first clinical use in Poland of a high-speed videoendoscopy (HSV) system with laser illumination — the Advanced Larynx Imager System (ALIS) — for assessing glottal phonatory function. A total of 40 patients were examined, first using classical laryngovideostroboscopy (LVS) and then HSV with the ALIS system. The imaging system stood out due to its full-color recording capability, lightweight camera head, and ability to provide continuous and intense illumination without overheating — advantages emphasized by the authors as resulting from the use of laser-based lighting.

Two clinical cases:

A female patient with no visible glottic pathology: HSV revealed subtle phonatory irregularities (tendency toward hyperfunction) not visible in LVS.
A patient with a vocal fold: HSV enabled visualization of vibratory irregularities, mucosal wave disruption, and reflected wave patterns on both folds.

Findings:
In both cases, HSV allowed for:

more precise analysis of phonatory function,
visualization of kymograms and glottal width waveform (GWW) plots,
calculation of vibratory frequency and amplitude parameters.

Conclusions:
HSV with laser illumination enables much more accurate assessment of phonation compared to LVS. Thanks to high temporal and color resolution, it allows for the analysis of irregular vocal fold vibrations and detection of subtle pathologies that may be missed using conventional methods. The authors note that this is a preliminary report and further studies involving larger patient groups are needed.

Significance of the DiagNova systems:
The study utilized the ALI-Cam-HS1 system with laser illumination from DiagNova, which enabled high-quality imaging of dynamic vocal fold motion in clinical conditions amd DiagnoScope Specialist software for data analysis. The authors highlight the advantages of the lightweight camera head and the ability to maintain continuous, bright illumination without overheating. The study emphasizes the clinical value of the DiagNova system as a next-generation diagnostic tool in otolaryngology.

Comparative analysis of high-speed videolaryngoscopy images and sound data simultaneously acquired from rigid and flexible laryngoscope: a pilot study

Wioletta Pietruszewska , Marcin Just, Joanna Morawska , Jakub Malinowski , Joanna Hoffman , Anna Racino, Magda Barańska , Magdalena Kowalczyk , Ewa Niebudek-Bogusz ,
Scientific Reports, 2021, 11:20480
DOI: 10.1038/s41598-021-99948-9 • full text

Study overview:
This pilot study aimed to compare high-speed videoendoscopy (HSV) images and simultaneously acquired acoustic data recorded using two optical paths: a rigid endoscope and a flexible fiber-optic endoscope. The goal was to evaluate whether flexible laryngoscopy can serve as a valid diagnostic alternative to traditional rigid HSV in clinical phonatory assessment.

Findings:

both rigid and flexible approaches enabled high-quality HSV image capture and synchronized audio recording.
Flexible fiber-optic endoscopy provided sufficient image quality for analyzing key vocal fold parameters, including glottal closure, open quotient, and fundamental frequency.
No significant differences in acoustic signal quality were observed between the two techniques.
Flexible laryngoscopy allowed more natural phonation, especially beneficial for patients with hypersensitive gag reflex or discomfort during rigid laryngoscopy.

Conclusions:
High-speed videoendoscopy using a flexible fiber-optic endoscope offers diagnostic image and sound quality comparable to rigid HSV. It is a viable alternative for patients intolerant to traditional rigid approaches, expanding the applicability of HSV in clinical settings.

Significance of the DiagNova systems:
The study employed the DiagNova ALIS (ALI-Cam-HS1) high-speed imaging system in both rigid and flexible configurations and DiagnoScope Specialist software for data analysis. The camera, equipped with a laser light source, captured real-time vocal fold vibrations at up to 3200 fps and enabled synchronous phonation recording. The DiagNova system demonstrated high diagnostic reliability and flexibility, supporting the extension of HSV applications to more challenging patient groups and enabling advanced phonatory assessment under natural voice conditions.

Perceptual and acoustic voice analysis in patients with glottis cancer after endoscopic laser cordectomy

Bożena Kosztyła-Hojna , Jarosław Łuczaj , Greta Berger, Emilia Duchnowska , Maciej Zdrojkowski , Anna Łobaczuk-Sitnik , Jolanta Biszewska
Otolaryngologia Polska, 2020, 74(3): 23–28
DOI: 10.5604/01.3001.0013.7850 • full text

Study overview:
The study evaluated perceptual and acoustic voice quality in 30 male patients treated for glottic cancer via CO₂ laser cordectomy types III, IV, and Va. Voice assessment was performed 6 months post-surgery and compared with a control group of 30 healthy men.

Methods:

Perceptual voice assessment: GRBAS scale
Acoustic analysis: DiagnoScope Specjalista software
Parameters: F0, Jitter, Shimmer, NHR, MPT
Additional FFT spectrogram analysisFFT

Findings:

Best voice quality (średnio G1R1B0A0S0) observed after type III cordectomy
Worst phonation pathologies - (G2R1B1A0S3) were seen after type Va
Acoustic markers Jitter, Shimmer i NHR increased with the extent of resection.
Shortest MPT: (4,8 s), observed after type Va; control group average: 22 s.
FFT analysis showed more non-harmonic components in type IV and Va patients.

Conclusions:
Voice quality after CO₂ laser cordectomy is strongly influenced by surgical extent. Greater resections correlate with more severe acoustic and perceptual impairments. Preservation of the anterior commissure led to better phonatory outcomes.

Significance of the DiagNova systems:
The study relied on DiagnoScope Specialist software., which enabled detailed and objective analysis of voice quality, supporting clinical evaluation of surgical impact on phonation.

Application of High Speed Digital Imaging (HSDI) technique and voice acoustic analysis in the diagnosis of the clinical form of Presbyphonia in women

Bożena Kosztyła-Hojna , Emilia Duchnowska , Maciej Zdrojkowski , Anna Łobaczuk-Sitnik , Jolanta Biszewska
Otolaryngologia Polska, 2020; 74(5): 24–30
DOI: 10.5604/01.3001.0014.1580 • full text

Study overview:
This study aimed to diagnose the clinical form of presbyphonia in elderly women using High-Speed Digital Imaging (HSDI) and acoustic voice analysis. The examined group included 50 women with dysphonia (mean age: 69), and the control group included 30 women without voice disorders (mean age: 71). Laryngeal imaging was performed with HSDI system by Richard Wolf GmbH using a high-speed camera (HS) and a 90° rigid endoscope. Acoustic assessment was conducted with Diagnoscope Specjalista software (DiagNova Technologies), analyzing F0, Jitter, Shimmer, NHR, and Maximum Phonation Time (MPT).

Findings:

78% of the study group showed vocal fold edema, increased mass, vibration asymmetry, reduced mucosal wave (MW), glottal insufficiency type D, and elevated Open Quotient (OQ) in the posterior glottic segment. Acoustic findings included reduced F0 (~164 Hz), increased Jitter, Shimmer, NHR, and reduced MPT (~11 s).
22% showed signs of vocal fold atrophy: reduced mass, mild asymmetry, reduced amplitude and MW, glottal insufficiency type E, with acoustic signs of slightly lowered F0 (~195 Hz), increased NHR, and reduced MPT (~12 s).
Acoustic analysis:

edema: reduced F0 (avg. 164 Hz), increased jitter, shimmer and NHR, shortened MPT (avg. 11 s),
atrophy: slight reduction in F0 (195 Hz), elevated NHR, shortened MPT (12 s),
control group: values within normal range (F0: 198 Hz, MPT: 19 s).

Conclusions:
HSDI and acoustic voice analysis allow for clear differentiation of presbyphonia subtypes (edematous vs. atrophic). This objective approach improves diagnostic accuracy and informs targeted voice therapy and rehabilitation.

Significance of the DiagNova systems:
The study utilized a high-speed camera by Richard Wolf and the DiagnoScope Specialist software. from DiagNova Technologies, which were essential in identifying and differentiating clinical presentations of presbyphonia in elderly women.

The application of High-Speed camera (HS), acoustic analysis and Voice Handicap Index (VHI) questionnaire in diagnosis of voice disorders in elderly men

Bożena Kosztyła-Hojna , Maciej Zdrojkowski , Emilia Duchnowska
Otolaryngologia Polska, 2019, 73(5): 25–30
DOI: 10.5604/01.3001.0013.3335 • full text

Study overview:
This study aimed to diagnose presbyphonia in elderly men using High-Speed Digital Imaging (HSDI), acoustic analysis, and the Voice Handicap Index (VHI). The study group included 50 non-professional voice users aged 61–72, compared with a control group of 30 healthy men aged 29–38.

Methods:

Laryngeal visualization: HSDI (High-Speed Digital Imaging) technique using a high-speed camera.
Vocal fold vibration analysis: mucosal wave morphology and glottal closure patterns.
Acoustic analysis: DiagnoScope Specialist software (DiagNova Technologies).
Subjective voice assessment: VHI (Voice Handicap Index) questionnaire.

Findings:

All patients in the study group presented with glottal insufficiency and mucosal dryness.
62%: reduced mucosal wave and physiological or slightly decreased vibration amplitude.
38%: increased vibration amplitude with irregularity.
Glottal closure patterns: 56% – type E; 38% – coexistence of types E and C (ELS classification).
Acoustic parameters (jitter, shimmer, NHR) were pathological in 96% of patients.
MPT: shorter in the study group (12 s vs. 26 s in the control group).
VHI scores: mild voice handicap – 30%, moderate – 44%, severe – 26% of patients.

Conclusions:

The HSDI technique using a high-speed camera enables effective differentiation between hypofunctional dysphonia and vocal fold atrophy.
Acoustic and spectral analysis parameters support and confirm the imaging findings.
Subjective voice assessment (VHI) highlights the importance of objective diagnostics in older adults.

Significance of the DiagNova systems:
The study utilized an HSDI high-speed camera from the R. Wolf system and the DiagnoScope Specialist software software by DiagNova Technologies. Data analysis in the software enabled precise evaluation of the mucosal wave and glottal closure patterns, providing significant support in the diagnosis of presbyphonia.

Analysis of voice quality parameters in patients with vestibular voice

Bożena Kosztyła-Hojna , Anna Łobaczuk-Sitnik , Maciej Zdrojkowski , Emilia Duchnowska , Diana Moskal-Jasińska , Anna Kraszewska , Anna Twarowska , Jolanta Biszewska
Otolaryngologia Polska, 2019, 73(3): 11–15
DOI: 10.5604/01.3001.0012.8373 • full text

Study overview:
This study assessed voice quality parameters in women with vestibular phonation using perceptual evaluation (GRBAS), laryngeal imaging (endoscopy, stroboscopy, HSDI), and acoustic/aerodynamic analysis. Forty women were enrolled: 20 with vestibular voice (Group I) and 20 with normal phonation (Group II).

Findings:

95% of Group I patients had hyperfunctional dysphonia; 5% had paralytic dysphonia.
GRBAS results: hoarseness (95%), roughness (75%), and tension (55%).
HSDI imaging (HRES Endocam 5562) revealed asymmetrical, irregular vocal fold vibration, reduced mucosal wave, and posterior glottic insufficiency.
Acoustic analysis (Diagnoscope Specjalista) showed increased jitter, shimmer , NHR, nonharmonic components, and decreased F0 and MPT.
Group II showed normal values across all parameters (MPT: 22.2 s vs 13.95 s in Group I).

Conclusions:
Vestibular phonation commonly co-occurs with psychogenic hyperfunctional dysphonia or compensatory patterns in vocal fold paralysis. HSDI and acoustic analysis are effective for objective diagnosis and differentiation.

Significance of the DiagNova systems:
Although the imaging hardware came from a competing manufacturer (Richard Wolf GmbH), the use of DiagnoScope Specialist software was central to acoustic analysis, enabling objective measurement of phonatory disturbances critical for diagnosing vestibular voice.

Acoustic and capacity analysis of the vocal organ in patients with functional and organic larynx disorders using the DiagnoScope Specialist software

Kalina Owczarek , Piotr Niewiadomski , Jurek Olszewski
Otolaryngologia Polska, 2019, 73(4): 14–20
DOI: 10.5604/01.3001.0013.1535 • full text

Study overview:
The aim of the study was to evaluate the utility of the Diagnoscope Specjalista software (DiagNova Technologies) in the acoustic and capacity-based assessment of the vocal organ in patients with functional and organic dysphonia. The study group consisted of 131 adult patients (75 women, 56 men) aged 21 to 82.

Methods:

Medical history and ENT examination
Videolaryngoscopic assessment of phonation
Subjective voice evaluation by patients and specialists
Acoustic and aerodynamic analysis using Diagnoscope Specjalista (DiagNova)
Lifestyle analysis (smoking, hydration, stress, fatigue)

Analyzed parameters included: fundamental frequency F0, jitter, shimmer, NHR, MPT (maximum phonation time), effective phonation time, phonatory efficiency coefficients, and voice capacity.

Findings:

F0 values were within or below physiological norms, depending on the dysphonia type and gender
Jitter and shimmer were highest in patients with organic lesions
The shortest phonation time and lowest phonatory efficiency coefficients were observed in patients with vocal fold paralysis and vocal nodules.
Voice capacity and efficiency were significantly reduced in organic and psychogenic dysphonia cases.

Conclusions:
The Diagnoscope Specjalista software enables comprehensive, objective assessment of voice quality, including acoustic, aerodynamic, and capacity-related parameters. It is a useful tool not only for diagnosis but also for monitoring the effects of voice therapy.

Significance of the DiagNova systems:
The study used only the DiagnoScope Specialist software from DiagNova Technologies (without high-speed imaging). This system allowed for detailed phonation analysis, which served as the basis for differentiating dysphonia types and evaluating therapeutic outcomes.

The usefulness of the acoustic and the capacity analysis of singing voice

Joanna Nowosielska-Grygiel, Jurek Olszewski
Otolaryngologia Polska, 2019, 73(3): 14–20
DOI: 10.5604/01.3001.0013.1534 • full text

Study overview:
This study aimed to assess the diagnostic usefulness of acoustic and functional (capacity) analysis of singing voice using DiagnoScope Specjalista software (DiagNova Technologies). A total of 120 adults (74 women, 46 men; mean age: 26.3) were divided into three groups:

Group I: professional singers (n=40)
Group II: semi-professional singers (n=40)
Group III: non-singers (n=40)

Participants underwent ENT examination, videoendoscopy, subjective GRBAS scale rating, and acoustic and capacity-based voice evaluation. Lifestyle factors (smoking, sleep, reflux, vocal training) were also assessed.

Findings:

The highest fundamental frequency (F0) values were observed in professional vocalists (316.46 Hz in women, 165.09 Hz in men).
Jitter and Shimmer were lower in singers compared to non-singers, indicating greater phonatory stability.
The NHR (noise-to-harmonics ratio) was also lower in the professional group.
Phonation time, aperiodicity coefficients, and vocal capacity were relatively low across all groups, with no statistically significant differences.
Significant differences were found for F0, PPQ, APQ, and NHR across groups and between sexes.

Conclusions:

Parameters such as jitter, shimmer, PPQ, APQ, and NHR, when combined with other assessment methods, have diagnostic and prognostic value in detecting voice disorders.
The performance-based singing analysis revealed low values for parameters such as phonation time, effective phonation time, aperiodicity index, vocal efficiency, and vocal capacity.
Objective voice analysis complements subjective assessment and classical otolaryngological examination, enabling more precise diagnosis and therapy monitoring.

Significance of the DiagNova system:
The DiagnoScope Specialist software by DiagNova Technologies played a key role in this study, enabling comprehensive voice analysis — both acoustic and functional. Its application made it possible to detect subtle differences in voice quality between groups and highlighted the system’s usefulness in evaluating professional voice as well as in clinical phoniatric diagnostics.

Verbal communication disorders in psychogenic dysphonia

Bożena Kosztyła-Hojna , Diana Moskal-Jasińska , Anna Kraszewska , Anna Łobaczuk-Sitnik , Maciej Zdrojkowski , Emilia Duchnowska , Jolanta Biszewska
Otolaryngologia Polska, 2019, s. 14–20
DOI: 10.5604/01.3001.0013.0999 • full text

Study overview:
This study aimed to assess verbal communication and phonatory features in women diagnosed with psychogenic dysphonia. Twenty-one patients (mean age: 40) underwent comprehensive ENT diagnostics, including laryngoscopy, stroboscopy, high-speed digital imaging (HSDI), and acoustic voice analysis.

Findings:

95% of patients showed increased laryngeal muscle tension and irregular vocal fold vibrations.
HSDI imaging revealed asynchronous vibration, phonation arrests, and incomplete glottal closure
• Acoustic analysis via Diagnoscope identified elevated jitter and shimmer, ophonatory breathiness, and instability.
Na podstawie wywiadów stwierdzono cechy zaburzeń komunikacyjnych o podłożu psychogennym, takich jak zaburzenia ekspresji, stylu wypowiedzi i ograniczony kontakt wzrokowy.

Conclusions:
• Interview data indicated disrupted verbal expression, reduced eye contact, and altered speech patterns consistent with psychogenic origin.

Significance of the DiagNova systems:
The study employed DiagnoScope Specialist software for precise acoustic voice analysis. While the imaging hardware was from a different manufacturer (R. Wolf GmbH), Diagnoscope proved to be a robust and compatible diagnostic platform, demonstrating its utility across diverse HSDI systems.

Parameters of the assessment of voice quality and clinical manifestation of rheumatoid arthritis

Bożena Kosztyła-Hojna , Diana Moskal , Anna Kuryliszyn-Moskal
Advances in Medical Sciences, 2015, Tom 60, s. 321–328
DOI: 10.1016/j.advms.2015.06.004 • full text

Study overview:
The aim of the study was to evaluate voice quality in patients with rheumatoid arthritis (RA) and to analyze correlations between voice disorders and the clinical manifestations of the disease. The study included 72 patients with RA (mean age 59.6 years) and 30 healthy controls. A comprehensive diagnostic approach was applied, including rheumatological assessment (DAS28, Steinbrocker scale), phoniatric interview, subjective evaluations (GRBAS, VHI), as well as modern methods of vocal fold visualization — digital stroboscopy, digital kymography, and high-speed digital imaging (HSDI). Acoustic parameters were also analyzed (including F0, Jitter, Shimmer, NHR, and MPT).

Findings:
Voice disorders were identified in 44.4% of patients with RA, most frequently of hypofunctional character, correlating with higher disease activity and more advanced joint changes. Phonatory parameters were markedly impaired compared to the control group — including shortened phonation time, increased Jitter, Shimmer, and NHR values, as well as asymmetry and irregularity of vocal fold vibrations.

Conclusions:
Voice disorders are a significant yet often underestimated symptom in patients with RA. Diagnostics utilizing modern tools such as HSDI and acoustic analysis allows detection of subtle changes in laryngeal function. Interdisciplinary cooperation between rheumatologists and phoniatric specialists is strongly recommended in the treatment process.

Significance of the DiagNova systems:
The study employed high-speed digital imaging (HSDI) technology ALI-Cam-HS1, the light source with DiagnoScope Specialist software as one of the key methods for objective evaluation of vocal fold vibrations. This system enabled detailed analysis of the phonatory pathway and detection of subtle changes undetectable by conventional stroboscopic examination. Although the equipment manufacturer was not specified in the publication, the HSDI method represents a core diagnostic approach with potential application relevance to DiagNova systems.

Acoustic and capacity analysis of voice academic teachers with diagnosed hyperfunctional dysphonia by using DiagnoScope Specialist software

Hanna Zielińska-Bliźniewska , Piotr Pietkiewicz , Jarosław Miłoński , Joanna Urbaniak, Jurek Olszewski
Otolaryngologia Polska, 2013, 67(2): 144–148
DOI: 10.1016/j.otpol.2013.02.001 • full text

Study overview:
The aim of the study was to assess acoustic and performance-based voice parameters in female university lecturers diagnosed with hyperfunctional dysphonia, using the DiagnoScope Specialist software by DiagNova Technologies. The study included 46 women aged 34–48, all working as academic teachers and presenting no organic laryngeal pathology. The assessment involved medical interview, videolaryngoscopy and stroboscopy, as well as acoustic and performance analysis performed with the DiagnoScope Specialist software. The analyzed parameters included:

Acoustic: F0, Jitter, Shimmer, RAP, APQ, HPQ, NHR, Yanagihara coefficient, formants F1–F4
Performance-based: phonation time, effective phonation time, phonation break coefficient, vocal efficiency, and vocal capacity

Findings:

Increase in pathological parameters: Jitter (+100%), RAP (+81.8%), NHR (+13.4%), U2H (+16%), APQ (+2.9%).
Decrease in: Shimmer (–2.5%), formants F1–F4, R2H (–35.1%), HPQ, RHPQ, and the Yanagihara coefficient (–20.2%).
Phonation time and vocal capacity were significantly lower than reference values.
GRBAS assessment confirmed moderate voice disorders in all participants.

Conclusions:

Acoustic analysis revealed significant frequency disturbances and increased noise-related parameters in patients with hyperfunctional dysphonia.
Performance analysis demonstrated markedly reduced phonatory parameters and vocal capacity.
The DiagnoScope Specialist software enables objective evaluation of vocal function and may support diagnostics of occupational voice disorders.

Significance of the DiagNova systems:
The DiagnoScope Specialist system played a key diagnostic role in this study, enabling comprehensive voice assessment in academic lecturers with hyperfunctional dysphonia. Its application allowed precise identification of functional impairments and supported the findings obtained through clinical and stroboscopic examination.

Evaluation of vocal acoustic and efficiency analysis parameters in medical students and academic teachers with use of IRIS and DiagnoScope Specialist software

Hanna Zielińska-Bliźniewska , Wiesław J. Sułkowski, Piotr Pietkiewicz , Jarosław Miłoński , Joanna Urbaniak, Agnieszka Mazurek , Jurek Olszewski
International Journal of Occupational Medicine and Environmental Health, 2012, 25(3): 236–241
DOI: 10.2478/S13382-012-0030-x • full text

Study overview:
This study compared the diagnostic usefulness of DiagnoScope Specialist (DiagNova Technologies) and IRIS software in assessing vocal acoustic and efficiency parameters in professional voice users – female medical students and academic teachers.

Methods:

40 women were examined (20 students, 20 academic teachers). The study included:
The study included videolaryngoscopy and stroboscopy.
An acoustic voice analysis was performed using the IRIS system and the Diagnoscope Specialist software.
The performance-based voice assessment (effective phonation time, efficiency coefficients) was carried out exclusively in Diagnoscope Specialist.

Findings:

High consistency was achieved between IRIS and Diagnoscope Specialist across all parameters except the F4 formant.
The Diagnoscope software included predefined normative values for the analyzed parameters, which facilitated result interpretation.
Only Diagnoscope enabled performance-based phonatory assessment, including effective phonation time and vocal efficiency indicators.
The results confirmed the usefulness of Diagnoscope in clinical practice and in the evaluation of occupational voice disorders.

Conclusions:
The Diagnoscope Specialist software is a useful tool in the diagnostics of voice disorders among professional voice users. It outperforms the IRIS system, offering not only acoustic analysis but also functional assessment of phonatory performance, together with normative data, making it a more comprehensive diagnostic solution.

Significance of the DiagNova systems:
The study demonstrated greater functionality and clinical applicability of the DiagnoScope Specialist software compared with IRIS. The software enabled a thorough and objective voice assessment in occupational settings, even though HSV technology was not utilized in this particular project.

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