GET A STROBE!

May 3rd, 2021

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GET A STROBE!

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If you ever notice a change in your voice lasting longer than two weeks, it’s a GREAT idea to go see a laryngologist or ENT or a voice-specialized speech pathologist that can perform a videostroboscopy on you. What exactly does this mean and why do you need it??

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First off, if we never see the INSIDE, we are only guessing about what’s causing a change in your voice—and this is never the right decision. YOUR VOICE is YOUR INSTRUMENT, and definitely something you should prioritize related to finding out all you can about its health, function, and “current status”. 

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Two different simple outpatient non-invasive procedures/examinations can “take a look” at your vocal folds: a flexible laryngoscopy and a videostroboscopy.

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During a flexible laryngoscopy, a flexible endoscope is inserted into one the nostrils (although both can be “checked” to assess nasal passageways, sinuses, etc.) to provide a view of the structures and functions of the larynx (voice box). It is more of a “quick look” at the structures of the nose, pharynx (throat), and larynx (voicebox) and can provide information about movement and any apparent abnormalities.

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A videostroboscopy is a more detailed and comprehensive instrumental examination for viewing the anatomy, structure, function, and vibratory parameters/dynamics of the vocal folds. Two different scopes can be used—one that goes in the mouth (rigid scope) or one that goes in the nose (flexible scope). Normally, a specific protocol is utilized where some vocal tasks are performed with a halogen light on first and then a stroboscopy light is turned on and additional vocal tasks are performed. I always tell patients that the stroboscopy light is “like a strobe light at a disco party” and it allows the reallllyyyy fast vibratory movements of the vocal folds to slow down so that we can actually assess the parameters with our naked eye (and this tells us A LOT about your voice and its function).  DID YOU KNOW vocal folds normally vibrate anywhere from 100-1000 times per SECOND, depending on the pitch of the sound we make?! That’s really fast for two small, delicate pieces of multi-layered tissue(!), and the stroboscopy light allows us to visualize this vibration in slow-motion.  Another perk of this non-invasive, magnified, slow-motion procedure is that the whole time it’s being performed, a MOVIE is also being recorded(!). AND immediately afterwards, the movie is reviewed with the patient so that you can understand the suspected reasons for your dysphonia/hoarseness and you can see the inside of your own larynx! One of my favorite things to do is to introduce patients to their own anatomy and provide education to them about their voice—what it looks like, how it is functioning, and what that means relative to how they sound.

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A videostroboscopy is an ESSENTIAL tool for “finding out what’s wrong with your voice”. Without visualization of the vocal folds (using a stroboscopic light and recording function), it’s very easy to miss something important. In a 2015 study, it was found that 47.9% (roughly half) of diagnoses were altered after videostroboscopy, when the first exam was laryngoscopy (Cohen et al., 2015). Check out the video featured here as well, which is from a strobe I recently did at the clinic—these findings were not mentioned on the laryngoscopy report. I was able to provide the doctor with valuable information and pictures that guided the plan of care (and provided the patient important insight into his persistent globus sensation a.k.a. feeling that “something was stuck” in the throat/lump in the throat feeling).

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So, remember the importance of TAKING A LOOK and prioritizing a VIDEOSTROBOSCOPY if anything has changed related to the quality of your voice.

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