|
Laryngoscopy/Stroboscopy: Comparing Exams
Key Glossary Terms
Rigid Laryngoscopy
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
Flexible Laryngoscopy
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)
Stroboscopy
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 |
|
What are the advantages and limitations of each voice box viewing technique?
Pros and Cons of Each Examination Technique
| Type of Viewing |
Advantages |
Limitations |
Mirror examination |
- Inexpensive
- No need for specialized equipment
- Performed by all otolaryngologists
|
- Limited viewing of the voice box
- Images not recorded
|
Rigid laryngoscopy |
- Magnified viewing with clearest detail
- Images recorded on video or DVD, allowing review and frame-by-frame analysis
|
- Done with tongue protruded and held by examiner; as a result, examination of voice box function is limited
- Expensive equipment
|
Flexible laryngoscopy |
- Magnified viewing of the voice box while allowing patient to sing, speak, etc.
- Images recorded on video or DVD, allowing reviews and frame-by-frame analysis
|
- Image not as clear as rigid laryngoscopy
- Expensive equipment
|
Mirror Examination
Advantages
The mirror examination is inexpensive, does not require specialized equipment, and can be
performed by all otolaryngologists.
Limitations
Mirror laryngoscopy provides a limited examination of the voice box,
and does not allow images to be recorded. The medical record of a
mirror exam is simply the verbal description of the examiner's findings.
Rigid Laryngoscopy
Advantages
Rigid laryngoscopy provides the clearest and most magnified view of
the voice box and vocal folds. It is the best viewing technique to
investigate voice disorders caused by structural abnormalities of the
vocal folds, such as vocal fold cysts, polyps, nodules, granuloma,
scars, etc. It is also the most commonly used viewing technique for
stroboscopy.
Limitations
Because the tongue is protruded and held by the examiner, viewing
the voice box "in action" is limited to simple sound production, such
as "eee".
Flexible Laryngoscopy
Advantages
A key advantage of flexible laryngoscopy is that the patient can be
examined in a natural posture, and the voice box and vocal folds can be
viewed while the patient performs different voice tasks, such as
speaking and singing. This assists the clinician in determining if the
voice problem comes from specific activities of the larynx during these
various tasks. It is also extremely helpful in determining whether a
patient's voice disorder is caused by a "functional problem" such as muscle tension dysphonia or spasmodic dysphonia. (For more information, see Spasmodic Dysphonia.)
Disadvantages
The main downside to this examination technique is that the clarity
of the image is not as good as rigid telescopic laryngoscopy.
|
