Some Issues and Ethics in Oral and Nasal Videoendoscopy

Department of Speech Pathology and Audiology, School of Medicine, University of Nevada, Reno, Nevada. The use of endoscopy by the speechlanguage pathologist (SLP) to evaluate and treat voice and resonance disorders is rapidly increasing (Bless et al., 1987). One reason for this popularity is that endoscopy permits safe viewing of the speech mechanism from vocal tract locations that were previously inaccessible. Endoscopy is especially useful for examining dynamic movements of the velopharyngeal (VP) mechanism or the larynx and a permanent video record (videoendoscopy) can be obtained simultaneously. Because endoscopy has such important applications to the study of vocal tract function, it has been a natural consequence that SLPs have been among the pioneers in development of endoscopic procedures and techniques (Bless et al., 1987; D'Antonio et al., 1986; Ibuki et al., 1983; McFarlane and Lavorato, 1984; Siegel-Sadewitz and Sphrintzen, 1982; Watterson et al., 1987). In some clinical situations, the SLP has contributed by observing patient behavior and eliciting an appropriate speech sample as the endoscope is manipulated by a physician (D'Antonio et al., 1986), while in other clinics, SLPs have developed endoscopic protocol and techniques independent of the physician, but with the advice and consent of the ENT community (McFarlane and Lavorato, 1984; Watterson et al., 1987). This chapter will focus on some important issues and ethical considerations inherent to the practice of vocal tract endoscopy with special reference to the role of the SLP.