Videostroboscopy is a useful technique for evaluating the larynx. It uses synchronized flashing light passed through an endoscope to visualize vocal fold vibration in slow motion. This allows examination of vocal fold biomechanics, laryngeal mucosa, and mucosal vibration. Videostroboscopy can detect vocal fold lesions and other pathologies, helping to plan surgery and treatments for voice problems. The procedure involves calibrating a microphone, inserting a rigid or flexible endoscope, and having the patient phonate so vocal fold vibration can be observed. Common findings include vocal cysts, polyps, and nodules, which impact mucosal wave and glottic closure.

1. PRESENTER: DR. ARJUN SURESH

2.  Videostroboscopy - practical and useful technique - clinical
evaluation - visco-elastic properties of phonatory mucosa.
 Painless, OPD-based procedure
 Essential evaluation of laryngeal mucosa, vocal fold motion
biomechanics, and mucosal vibration.
 Helps detect pathology - determine impact on voice and airway
function.

3.  Method used to visualize vocal fold vibration.
 Uses synchronized, flashing light passed via flexible or rigid
telescope
 Flashes of light are synchronized to vocal fold vibration at
slightly slower speed, allowing examiner to observe it during
sound production in slow motion

4.  Essential for planning effective phonomicrosurgery.
 Real-time information - nature of vibration, image to detect vocal
pathology, and permanent video record of examination.
 Improves sensitivity of subtle laryngeal diagnoses.
 Helps evaluate:
1. Vocal fold biomechanics
2. Laryngeal mucosa
3. Mucosal Vibration

5. • Cause of voice dysfunction or hoarseness - vocal cord swelling,
irritations, misuse, growths, polyps or acid reflux.
• To visualize your vocal cords
• To evaluate or detect vocal cord lesions and other irregularities
like inflammation, scar tissue or muscle tension conditions
• To assess swallowing issues, which could be caused by muscle
abnormalities

6. You may be a candidate for videostroboscopy if you're
experiencing chronic or intermittent voice problems like:
 Breathiness, hoarseness, decreased or loss of vocal range or
vocal fatigue
 Tightness, discomfort or pain or burning in your throat while
talking
 The feeling of "something in your throat“ (foreign body
sensation)
 Symptoms and hoarseness caused by acid reflux

8.  A strobe - visualize the mucosal waves across the vocal folds.
 Synchronized to the frequency of the voice.
 The mucosal waves are too fast for the human eye to appreciate.
 The strobe slows this process by visualizing the mucosal wave across
several cycles of vocalization.
 Mucosal waves originate upon contact or closure of the vocal folds
and move from a medial to lateral direction
 Mucosal folds are at the same position on both vocal folds at any
particular time

9.  No absolute CI – patient should have adequate mouth opening
and patent nasal airway.

10. A videostroboscopic unit:
 A stroboscopic light source and microphone,
 Video camera
 Endoscope
 Video recorder.
Stroboscopy can be performed by using either rigid or flexible
Endoscopes.

11. Standard 70-degree rigid
strobolaryngoscope.
Camera attachment with mounted
microphone
Laryngeal microphone
flexible laryngostroboscope

12.  Videostrobolaryngoscopy begins by seating the patient in the
examination chair at a height comfortable for the examiner.
 The patient leans forward with the neck flexed and the head
extended at the atlo-occipital joint (Kirstein position).

13.  Once the patient is in appropriate position,
 Spray topical anesthesia – posterior part of tongue and
oropharynx.
 Calibrate microphone and hold against thyroid lamina.
 To avoid condensation – dip scope in hot water.
 Open mouth, protrude tongue- scope is inserted.
 Proper focus – visualise subepithelial vasculature of vocal
fold.

14.  With Vocal folds in focus – ask patient to produce ‘ee’ sound.
 Should be done at low, mid and high frequency pitches and
different volumes.
 Examiner - comment on arytenoid and vocal fold mobility,
glottic closure pattern, mucosal wave, and pliability.
 Ulcerative lesions or masses can also be observed.

15. 1. VOCAL CYST
- Encapsulated, spheroid lesions - mucus or keratin
- Located - lamina propria of the vocal fold.
- Keratin cysts - likely congenital & mucous cysts - likely acquired.
- Generally unilateral, though several may be present at the time of
diagnosis.
- On stroboscopy, region of the cyst - diminished pliability - mucosal wave
does not propagate normally through the region of the cyst.
- Mucosal-wave deficit - size and location of the cyst.
- Illustrated by the fact - small superior-surface cysts minimally affect vocal
function.

17.  Unilateral or bilateral.
 Represent phonotraumatic pathology - collision forces, shearing
stresses - lamina propria.
 Consistency - gelatinous to fibrotic.
 Glottic closure – compromised - gaps anterior and posterior to the
lesion in maximal closure.
 The vibratory patterns of VC – asymmetric - diminution of vibration
near the lesion.
 Medial surface polyp - disturbs the vibratory pattern - contralateral
vocal fold during closure.

19.  Bilateral fibrovascular lesions - symmetric sessile masses.
 Occur in the center of the musculomembranous region -
basement-membrane - between the overlying epithelium and
the underlying superficial lamina propria.
 Glottic closure is compromised - high pitch frequencies.
 Mucosal wave - usually preserved bilaterally - pliability and
amplitude - decreased in the region of the nodule.