Detection-Gated Glottal Segmentation with Zero-Shot Cross-Dataset Transfer and Clinical Feature Extraction

Background: Accurate glottal segmentation in high-speed videoendoscopy (HSV) is essential for extracting kinematic biomarkers of laryngeal function. However, existing deep learning models often produce spurious artifacts in non-glottal frames and fail to generalize across different clinical settings. Methods: We propose a detection-gated pipeline that integrates a YOLOv8-based detector with a U-Net segmenter. A temporal consistency wrapper ensures robustness by suppressing false positives during glottal closure and instrument occlusion. The model was trained on a limited subset of the GIRAFE dataset (600 frames) and evaluated via zero-shot transfer on the large-scale BAGLS dataset. Results: The pipeline achieved state-of-the-art performance on the GIRAFE benchmark (DSC 0.81) and demonstrated superior generalizability on BAGLS (DSC 0.85, in-distribution) without institutional fine-tuning. Downstream validation on a 65-subject clinical cohort confirmed that automated kinematic features (Open Quotient, coefficient of variation) remained consistent with established clinical benchmarks. The coefficient of variation (CV) of the glottal area was found to be a significant marker for distinguishing healthy from pathological vocal function (p=0.006). Conclusions: The detection-gated architecture provides a lightweight, computationally efficient solution (~35 frames/s) for real-time clinical use. By enabling robust zero-shot transfer, this framework facilitates the standardized, large-scale extraction of clinical biomarkers across diverse endoscopy platforms. Code, trained weights, and evaluation scripts are released at https://github.com/hari-krishnan/openglottal.