Transnasal Videoendoscopy of the Laryngeal Mechanism
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Repint re uests: Dr. McFarlane, Department of A Speech Pat ology and Audiology, Room 108 M.S., School of Medicine, Uniuersig of Nevada, Reno, 8 NV 89577. As we discussed in the first chapter of this monograph, observation of the larynx during speechlvoice production is of enormous value to the speech pathologist in evaluation and treatment of voice disorders, and serves a different purpose or function from the examination performed by the ENT physician. This chapter will explain the equipment, procedures, protocol, purpose, interpretation, and advantages of transnasal observation by the SpeechILanguage Pathologist of the larynx during speechlvoice production. In the department of Speech Pathology and Audiology at the School of Medicine, University of Nevada-Reno we perform transnasal endoscopy (and stroboscopy) of the larynx daily. This has been an invaluable tool in the development of a definitive understanding of individual "difficult to diagnose patients" referred by various E N T physician colleagues. Perhaps, even more importantly, we have been able to conduct research which has added to our understanding of various voice disorders and the effects of various treatment procedures. For example, we (Watterson et al., 1987) were able to determine why patients with teflon injected paralyzed vocal cords may have been judged by listeners (ENT physicians, speech pathologists, and lay listeners) to present significantly poorer vocal quality than similar patients treated by voice therapy or by muscle nerve reinervation as reported by McFarlane, Holt, and Lavorato (1985). Another example of the value of this instrumentation and techniques is the study (McFarlane and Watterson, 1987) in which variations in the number and location of vocal nodules were reported. For the first time multiple nodules (three or four nodules) were reported and the relationship of vocal use (singing) was suggested as a hctor in the presence of multiple nodules and in the specific location of nodules (e.g., posterior versus anterior site). The various uses of transnasal laryngeal video endoscopy and stroboscopy in the diagnosis and treatment of different types of voice disorders is discussed by McFarlane and Lavorato (1984), and further discussed by Boone and McFarlane (1 988).
[1] A. Menicucci,et al. Vibratory characteristics of Teflon-injected and noninjected paralyzed vocal folds. , 1990, The Journal of speech and hearing disorders.
[2] S. Mcfarlane. Treatment of benign laryngeal disorders with traditional methods and techniques of voice therapy. , 1988, Ear, nose, & throat journal.