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An examination of the voice box in which a rigid telescope is used; this examination provides the clearest magnified detail of the voice box, but the patient is unable to speak or sing during the exam
An examination of the voice box in which a flexible fiberoptic scope is used; this examination allows the physician to view the voice box in action (i.e., while the patient is producing sound)
An examination in which a strobe light is combined with rigid or flexible laryngoscopy, allowing an examination of vocal fold vibration and vocal fold closure
Since many voice disorders are caused by problems in the voice box and/or throat, a careful and detailed examination of the voice box and throat is key to the identification of the cause or causes of voice disorders. Several methods can be used to examine the throat and voice box.
Viewing the Voice Box Through Specialized Tube (Endoscope)
Rigid laryngoscopy: This examination provides the clearest magnified view of the voice box. A rigid telescope-tube is passed through the patient’s mouth. The examiner then holds the patient’s tongue while viewing the voice box. Images are usually recorded on video.
Also called: telescopic laryngoscopy, transoral laryngoscopy
Flexible laryngoscopy: This examination allows for viewing the voice box in action. Flexible laryngoscopy provides a magnified view of the voice box while the patient produces sound (speaking, singing, etc.). Viewing is done through a flexible viewing-tube passed through the patient’s nose to the back of the throat, thus allowing the examiner to view the voice box while the patient speaks, sings, coughs, sniffs, etc. Images are usually recorded on video.
Also called: fiberoptic laryngoscopy, fiberoptic flexible endoscopy, nasopharyngoscopy, transnasal laryngoscopy
Laryngeal stroboscopy: This examination is a specialized viewing of vocal fold vibration. Laryngeal stroboscopy involves controlled high-speed flashes of light timed to the frequency of the patient’s voice. Images acquired during these flashes provide a slow motion-like view of vocal fold vibration during sound production.
Also called: videostroboscopy, laryngostroboscopy, laryngo-videostroboscopy, stroboscopic laryngoscopy, strobolaryngoscopy
These technologies provide valuable practitioner and patient information. They allow images to be recorded on video or other media formats, permitting examiners to review the images of the voice box frame by frame, capture still and close-up images, and re-review images with members of the voice care team. Patients can also view the recorded images and see the reason(s) for their voice problems. (For more information, see Voice Care Team.)
Who performs laryngoscopy and stroboscopy?
An otolaryngologist or speech-language pathologist typically performs laryngoscopy and/or stroboscopy. The examiner’s training and background experience is critical in performing and evaluating laryngoscopy and stroboscopy findings.
In certain situations, stroboscopy may be performed by a nurse practitioner or a physician assistant under the supervision of a physician.
Recording Laryngoscopy and Stroboscopy Findings
Flexible laryngoscopy, rigid laryngoscopy, and stroboscopy are frequently recorded on some type of playback media: videotape or DVD. The reasons for this are:
“Instant replay” review of examinations critical: The recorded images allow the clinician to review the examination repeatedly, often for a frame by frame analysis. This review of the examination of the voice box, vocal fold structure, vibration, and closure is analogous to the instant replay method used in televised sporting events. Playback media recording is especially important in stroboscopy because of the intricacy and rapid speed of vocal fold vibration.
Records for comparison over time: Recording the laryngeal examination on video allows comparison of voice box structure and function over time. By comparing old examinations of the voice box with a current examination, the voice care team can monitor the success or failure of various treatments and also observe any changes over time.
Patient education material presented here does not substitute for medical consultation or examination, nor is this material intended to provide advice on the medical treatment appropriate to any specific circumstances.
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