Dynamic voice assessment using flexible laryngoscopy—how I do it: a targeted problem and its solution

Abstract

Flexible laryngoscopy is a staple of the otolaryngologist’s office examination. This technique is frequently used for evaluation of gross pathologies of the larynx and pharynx as well as assessment of mobility of the vocal folds. By incorporation of a specific set of phonatory and vegetative tasks, the depth and detail of information gathered using flexible laryngoscopy can be greatly enhanced. Because the patient remains in a near-physiologic position, incorporation of these tasks into the flexible laryngoscopic examination provides essential information for the diagnosis of a variety of functional and neurologic disorders of the larynx and pharynx. Videostroboscopy can be performed by using the flexible laryngoscope, potentially circumventing the need for rigid endoscopic evaluation of small vocal fold lesions. By using this technique, subtle abnormalities of vocal fold motion can be detected, thus assisting in the diagnosis of vocal fold paresis and superior laryngeal nerve palsy. Here we describe a rapid but thorough method for evaluation of neurologic and functional voice and breathing disorders using flexible laryngoscopy (Table 1).