Leslie Wegner MS, CCC-SLP
Say cheese! It's picture day...for your vocal folds! What exactly is stroboscopy?
Updated: Jun 11, 2021
So your doctor has referred you for videostroboscopy. What on earth does that mean?
Videostroboscopy is a great tool to visualize the motion of the vocal folds in action. An easy way to understand this is to think about a hummingbird's wings. They flap too quickly for the human eye to see anything but a blur, and it's exactly the same with your vocal folds. This is where the strobe light comes in handy - the light flashes at the same frequency as the cords vibrating, and the camera can capture different moments in the vocal fold wave. When these points are put together in sequence, the characteristics of "motion" can be seen. There are two types of scopes used for stroboscopy:
1. Rigid Fiberoptic Oral Endoscopy or "rigid scope" - the vocal folds are assessed by passing a rigid tube into the mouth just far back enough for the lens on the end to get an image of the vocal folds.
Pros: It is a simple, painless, quick procedure that allows clinicians to get a great look at your vocal folds in action, and can be recorded for immediate playback. Cons: It is limited to prolonged, open vowels because you can't speak with the scope in your mouth. (unless you are a pro at Chubby Bunny) It can also be tricky if the patient has a sensitive gag reflex.
2. Flexible Fiberoptic Nasoendoscopy or "nasal scope" - a flexible nasoendoscope is gently passed through a nasal passage to visualize the vocal folds from above. The fiberoptic bundle shines a bright light in the larynx to capture images of the cords and throat. This procedure can be done with or without numbing the nasal passage.
Pros: Same as the rigid scope, plus you can also assess velopharyngeal competence, swallow, cough, and talking/humming/singing because you are up above the throat looking down!
Cons: Some patients find it a little uncomfortable, and a very, very few have some minimal bleeding in their nose when the scope is passed.
Research has shown that between 10-44% of the time, a general dysphonia diagnosis is changed after having a stroboscopy and specialty voice evaluation completed. I hate to admit, but I don't have stroboscopic vision. Very few humans have any kind of superpower. (except for this lady who can smell Parkinson Disease was before someone is diagnosed) We can be highly trained in voice, make really good guesses at what may be going on, and still be completely and utterly wrong.
THE WHO (are you, who who, who who) (sorry, can't resist)
These procedures are performed by ENTs who are usually laryngologists, speech language pathologists, and trained vocologists.
Stroboscopy is typically performed in ENT offices, hospitals, voice clinics, and in-home with mobile equipment.
Referrals for stroboscopy are usually made when any voice disorder is suspected - usually from an ENT/laryngologist, allergist, or PCP. We also see referrals from neurologists for voice treatment for patients with Parkinson's Disease.
In therapy, strobes can be used as a biofeedback tool during treatment to help the patient achieve resonant sounds in real-time, and to monitor progress of the vocal disorder.
We also provide baseline strobes to singers/actors/performers as a way to judge future vocal changes as they move through their careers.
North Texas Voice and Speech provides in-home videostroboscopy and FEES assessments and follow up therapy via telehealth.
Leslie Wegner, M.S., CCC-SLP, is a speech pathologist and voice teacher who specializes in singing/professional voice, swallowing, accent modification, and AAC. She is the owner of North Texas Voice & Speech, a member of ASHA Special Interest Group 3, Voice and Upper Airway Disorders, and is a proud Veteran musician of the US Army Band. Connect at www.ntxvoice.com, Instagram, LinkedIn, and Facebook.