Strobovideolaryngoscopy and Laboratory Voice Evaluation

Laryngeal examination in thyroid and parathyroid surgery: An American Head and Neck Society consensus statement

“…Laryngeal stroboscopy is a technique utilized to obtain a detailed evaluation of true vocal fold vibration. By using synchronized flashing light, stroboscopy creates a pseudo‐slow motion examination of the mucosal wave and vocal fold vibrations, which occur at speeds of 60 to 1500 cycles per second depending on phonatory pitch . The magnified, decelerated view is derived from time‐separated but cycle‐coordinated sequences from successive vocal fold vibrations, and allows increased insight into subtle pathological findings.…”

“…The patient is instructed to say “eee” while the camera is further advanced and/or rotated until adequate images of the larynx are obtained. These images are evaluated for symmetry, periodicity, mucosal wave, amplitude of vibration, glottic closure pattern, and the shape and contour of the vocal fold free edge . Periodicity describes the regularity of the vibratory cycles of the vocal folds, a feature important with regard to both identification of pathology (normal vocal folds are expected to have consistent, periodic vibratory cycles) and technical consideration (poor periodicity may prohibit useful synchronization of the strobe light and thereby limit its diagnostic utility) …”

“…By using synchronized flashing light, stroboscopy creates a pseudo-slow motion examination of the mucosal wave and vocal fold vibrations, which occur at speeds of 60 to 1500 cycles per second depending on phonatory pitch. 33,34 The magnified, decelerated view is derived from time-separated but cycle-coordinated sequences from successive vocal fold vibrations, and allows increased insight into subtle pathological findings. Rigid transoral examination is performed with the patient sitting upright, leaning forward, and slightly slouched in the examination chair.…”

“…These images are evaluated for symmetry, periodicity, mucosal wave, amplitude of vibration, glottic closure pattern, and the shape and contour of the vocal fold free edge. 33,35 Periodicity describes the regularity of the vibratory cycles of the vocal folds, a feature important with regard to both identification of pathology (normal vocal folds are expected to have consistent, periodic vibratory cycles) and technical consideration (poor periodicity may prohibit useful synchronization of the strobe light and thereby limit its diagnostic utility). 33 Stroboscopy is beneficial in the diagnosis of mucosal vocal fold abnormalities, including nodules, polyps, cysts, scar/sulcus, atrophy, subtle epithelial neoplasms, and pathologic anterior or posterior glottic gaps.…”

A Conscious Sedation Protocol for Videolaryngostroboscopy in Pediatric Patients

“…Videolaryngostroboscopy is a valuable diagnostic modality currently used successfully in the adult population to offer diagnostic information regarding laryngeal disorders and voice abnormalities [1]. It is widely used in adults but its use in pediatrics is limited because of the inability of many children to tolerate the procedure [2, 3].…”