The Role of Laryngoscopy and Videostroboscopy in Diagnosing Dysphonia

Close collaboration between otolaryngologists and SLPs can help patients avoid surgery or obtain optimal surgical results. “I may know that I could use surgical methods to resolve a patient’s problem, but sometimes, voice therapy may be all the patient needs or wants,” Dr. Courey said. “And if a patient is straining in a way that contributes to their voice problem, having the patient learn to stop straining is going to make my surgery much easier and more effective.”

Viewing the videostroboscopy helps SLPs plan voice therapy effectively. “Voice therapy today is physiologically based,” said Edie Hapner, PhD, CCC-SLP, assistant professor and director of speech language pathology at Emory University in Atlanta. “Up until the 1990s, we did symptomatic voice therapy. If you were too loud, we made your voice quieter. If you were too quiet, we made you louder, but we had no idea what was going on in the vocal folds. Now, we have the tools to look at them, so in order to design the most effective voice therapy, I need to understand what’s happening at the level of the vocal folds.”

Videostroboscopy can also be used to objectively document the success of vocal therapy, especially when the goal of therapy is to reduce a lesion’s impact or to reduce the size of the glottal gap.

“Laryngoscopy and stroboscopy are not new technologies, so many physicians are drawn to more complicated examinations like a CT scan, MRI, esophagoscopy, pH probe and testing for reflux before looking at the larynx,” Dr. Rosen said. “But we can use some simple, very valuable, effective techniques and find the actual cause of hoarseness by using laryngoscopy plus or minus a stroboscopy evaluation.”