Videostroboscopy of the Larynx
Feb 21, 2009
Videostroboscopy is a clinical evaluation tool, which allows one to directly observe the apparent motion of the larynx. This examination provides valuable information beyond that which the naked eye can see. It gives the clinician information regarding vocal fold vibration as well as an immediate and magnified image of the presence or absence of pathology. It can also document small changes in the vibratory capacity of the larynx as a result of a specific treatment modality. The presence of abnormal vibration may be detected using videostroboscopy long before the actual pathology becomes visually detectable to the naked eye. Videostroboscopy also provides a permanent record for documentation and comparison. Videostroboscopy has been found to be a valuable means for evaluating the degree of infiltration by cancerous lesions. Stroboscopy is also a very useful way to evaluate patients with vocal fold paralysis, because the onset of any improvement can often be observed earlier and with greater accuracy than with the eye or the ear.
Videostroboscopic evaluation of laryngeal functioning is routinely and easily performed in a clinic setting using either a rigid or flexible fiberoptic endoscope. In order to perform rigid oral endoscopy, the patient is asked to protrude the tongue and the clinician holds the tongue as a rigid tube is inserted into the mouth. The tube or scope, projects a high intensity light at a predetermined angle illuminating the structures to be observed and recorded. The advantages of this method are high illumination, a wide field of view, and excellent imaging capability. The disadvantages are that the procedure does interfere with normal speech production and there is some minor patient discomfort associated with the natural gag mechanism. However, the patient's discomfort is minimized with the use of a topical anesthetic spray.
Flexible fiberoptic endoscopy is performed with a flexible tube which is inserted through the nasal passage. Again, a high intensity light is transmitted through the flexible scope, which illuminates the structures to be viewed by the clinician, and/or recorded. In this procedure, one advantage is the excellent image of the vocal folds along with other structures of the oral cavity and throat. Since the small flexible scope is inserted through the nose, it does not interfere with the patient's ability to speak during the examination. The disadvantages are that the image is smaller than the image provided by rigid endoscopy, and the brightness of the image may be reduced. Again, possible patient discomfort is minimized with the use of a topical anesthetic spray administered into the nasal cavity. Both procedures allow the patient to go about their daily routine following completion of the evaluation.
The entire examination takes approximately 3-5 minutes, depending upon the experience of the examiner and the cooperation of the patient. Correct interpretation of the results requires knowledge and familiarity with the anatomy and physiology of the larynx, phonation, and the effect of potential pathologies on the vibratory functioning of the larynx. The technique is only one part of a clinical examination and is a valuable supplement to other currently used diagnostic procedures.
Videostroboscopic evaluation of laryngeal functioning is routinely and easily performed in a clinic setting using either a rigid or flexible fiberoptic endoscope. In order to perform rigid oral endoscopy, the patient is asked to protrude the tongue and the clinician holds the tongue as a rigid tube is inserted into the mouth. The tube or scope, projects a high intensity light at a predetermined angle illuminating the structures to be observed and recorded. The advantages of this method are high illumination, a wide field of view, and excellent imaging capability. The disadvantages are that the procedure does interfere with normal speech production and there is some minor patient discomfort associated with the natural gag mechanism. However, the patient's discomfort is minimized with the use of a topical anesthetic spray.
Flexible fiberoptic endoscopy is performed with a flexible tube which is inserted through the nasal passage. Again, a high intensity light is transmitted through the flexible scope, which illuminates the structures to be viewed by the clinician, and/or recorded. In this procedure, one advantage is the excellent image of the vocal folds along with other structures of the oral cavity and throat. Since the small flexible scope is inserted through the nose, it does not interfere with the patient's ability to speak during the examination. The disadvantages are that the image is smaller than the image provided by rigid endoscopy, and the brightness of the image may be reduced. Again, possible patient discomfort is minimized with the use of a topical anesthetic spray administered into the nasal cavity. Both procedures allow the patient to go about their daily routine following completion of the evaluation.
The entire examination takes approximately 3-5 minutes, depending upon the experience of the examiner and the cooperation of the patient. Correct interpretation of the results requires knowledge and familiarity with the anatomy and physiology of the larynx, phonation, and the effect of potential pathologies on the vibratory functioning of the larynx. The technique is only one part of a clinical examination and is a valuable supplement to other currently used diagnostic procedures.
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