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Updated: Apr 26, 2026

Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
[Hoarseness: biomechanisms and quantitative laryngoscopy]
1Abteilung für Phoniatrie und Pädaudiologie, Universitätsklinikum Erlangen, Bohlenplatz 21, 91054, Erlangen, Deutschland, ulrich.eysholdt@uk-erlangen.de.
Phonosurgery alters vocal fold anatomy, impacting voice production unpredictably. The updated European Laryngological Society protocol uses phonovibrograms to assess vocal fold vibration and estimate tissue elasticity for better phonosurgery indications.
Area of Science:
- Laryngology
- Bioacoustics
- Surgical Anatomy
Context:
- Phonosurgery inherently modifies laryngeal anatomy, affecting airflow and tissue elasticity.
- Predicting the precise impact of these alterations on voice quality remains challenging.
- Rational indications for phonosurgery require a comprehensive understanding of voice biomechanics.
Purpose:
- To elucidate the biomechanical principles underlying normal and disordered voice production.
- To explain the intricate relationship between vocal fold tissue viscoelasticity, glottal airflow, and sound generation.
- To outline the European Laryngological Society (ELS) criteria for phonosurgery indication assessment.
Summary:
- The article details the biomechanisms of voice production and disorders, emphasizing the interdependence of tissue properties, airflow, and sound.
- It reviews the five ELS evaluation criteria: patient self-rating, physician proxy rating, technical signal analysis, aerodynamics, and vibration analysis (stroboscopy).
- The updated ELS protocol incorporates the phonovibrogram (PVG) as a real-time method for visualizing vocal fold vibrations, replacing stroboscopy and enabling preoperative estimation of tissue elasticity.
Impact:
- Provides a framework for rational phonosurgery indications based on established evaluation criteria.
- Introduces the phonovibrogram as an advanced tool for assessing vocal fold dynamics and predicting surgical outcomes.
- Facilitates objective pre- and postoperative comparisons to evaluate the success of phonosurgical interventions.
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