Analysis of Mucosal Wave and Vibratory Patterns in Vocally Healthy Children and Adults.

Objective: To conduct a systematic investigation and comparison of the mucosal wave of vocal fold oscillations, the longitudinal anterior-posterior (AP) vibratory patterns of opening and closing, and posterior glottal gap in vocally healthy children (girls and boys) and adults (women and men). Methods: High-speed videoendoscopy (HSV) recordings of the sustained phonations of 40 subjects (10 men, 10 women, 10 boys, and 10 girls) were analyzed. For each recording, three sections of stable sustained phonation were selected. Two experts rated independently the anterior and posterior commissure points, the mucosal wave, and the AP vibratory patterns during the opening and closing phases of vocal fold vibration. A third rater mediated a consensus. Statistical significance between participant groups was evaluated using Pearson's chi-square test and post hoc Mann-Whitney U tests. Results: Mucosal wave amplitude was highest in children, whereas adult males exhibited lower amplitudes (p < 0.05). Posterior-to-anterior (p2a) opening patterns dominated in all groups, especially among children and females, while men showed more variation (p < 0.001). Anterior-to-posterior (a2p) closing pattern was most common in girls and females, whereas simultaneous (sim) closure was predominant in boys (p < 0.01). Posterior glottal gap was more frequently visible in children and females, while most adult males showed no visible gap (p < 0.001). Conclusion: This study identified age- and gender-related differences in vocal fold vibration. The findings offer key reference data for age-appropriate clinical visual-perceptual voice assessment.