OBJECTIVE: To investigate the instruments used by general otolaryngologists to visualize the larynx, assess the perception of the instruments' capabilities, and understand their comfort diagnosing specific etiologies of dysphonia. STUDY DESIGN: Cross-sectional survey. METHODS: One thousand randomly chosen general otolaryngologists from American Academy of Otolaryngology-Head & Neck Surgery were mailed a survey. RESULTS: The response rate was 27.8%. Mean years in practice were 19.5. Mirror and fiberoptic laryngoscopy were most commonly used. Approximately 84.1% used stroboscopy and 33.7% reported laryngoscopy could assess vibration. Respondents were more comfortable diagnosing conditions with obvious laryngeal structural abnormalities compared with those without, such as central neurologic disorders (P≤0.001). Approximately 46.5% were concerned about overdiagnosing laryngopharyngeal reflux (LPR). CONCLUSIONS: Although 84.1% of general otolaryngologists use stroboscopy, one-third may not appreciate the differences between stroboscopy and laryngoscopy. General otolaryngologists are less comfortable diagnosing voice disorders without obvious laryngeal structural abnormalities, and nearly 50% are concerned that they overdiagnose LPR.
[Show abstract][Hide abstract] ABSTRACT: Indirect laryngoscopy traditionally entails the use of both a head mirror and laryngeal mirror. It is the first and most basic successful technique for viewing the larynx, and arguably remains the most commonly used diagnostic method for laryngoscopy today. This article reviews its evolution, from Albucasis' early applications of reflection and succeeding experiments with refraction, to Hoffman's design of the head mirror and subsequent modifications with illumination, culminating in Manuel Garcia's description of mirror laryngoscopy in 1854 and its refinement by Türck and Czermak.
Annals of Saudi medicine 03/2013; 33(2):177-81. DOI:10.5144/0256-4947.2013.177 · 0.49 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To examine the responsiveness of the previously validated Singing Voice Handicap Index (SVHI) to treatment related changes in patients' singing voice.
Thirty singing patients at a tertiary voice clinic prospectively completed the Voice Handicap Index and SVHI at their initial presentation, pretreatment, and posttreatment.
Patients had lower SVHI scores posttherapy compared with the initial SVHI scores (P <or= .001, paired t-test). The change in SVHI scores from initial to posttreatment evaluation was greater than the change from initial to pretreatment evaluation (P < .001, paired t-test). The Spearman correlation of the Voice Handicap Index difference with the SVHI difference before and after treatment was 0.71 (P < .001).
The SVHI measures changes in patients' singing vocal health status resulting from treatment and the change correlates with that of other validated instruments.
The Laryngoscope 09/2008; 118(9):1705-8. DOI:10.1097/MLG.0b013e31817aec83 · 2.14 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Purpose of review:
To summarize recent technological advancements and insight into the role of stroboscopy in laryngeal imaging.
Although stroboscopic technology has not undergone major technological improvements, recent clarifications have been made to the application of stroboscopic principles to video-based laryngeal imaging. Also recent advances in coupling stroboscopy with high-definition video cameras provide higher spatial resolution of vocal fold vibratory function during phonation. Studies indicate that the interrater reliability of visual stroboscopic assessment varies depending on the laryngeal feature being rated and that only a subset of features may be needed to be representative of an entire assessment. High-speed videoendoscopy (HSV) judgments have been shown to be more sensitive than stroboscopy for evaluating vocal fold phase asymmetry, pointing to the future potential of complementing stroboscopy with alternative imaging modalities in hybrid systems. Laryngeal videostroboscopy alone continues to play a central role in clinical voice assessment. Even though HSV may provide more detailed information about phonatory function, its eventual clinical adoption will depend on how remaining practical, technical, and methodological challenges will be met.
Laryngeal videostroboscopy continues to be the modality of choice for imaging vocal fold vibration, but technological advancements in HSV and associated research findings are driving increased interest in the clinical adoption of HSV to complement videostroboscopic assessment.
Current opinion in otolaryngology & head and neck surgery 08/2012; 20(6). DOI:10.1097/MOO.0b013e3283585f04 · 1.84 Impact Factor
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