The contribution of videostroboscopy in daily ENT practice

Videostroboscopy has now left specialized voice laboratories and must be made available to general ENT practice. It is based on an optical illusion giving the impression of slow motion from a series of successive vocal cycles but it is the least awkward system to examine the movement of vocal folds while waiting for the development of very high speed video recordings which would enable to visualize a real single cycle. The equipment comprises a stroboscope, a CCD type of camera, a video recorder, a microphone, a monitor or television screen and rigid optics and/or a fiberscope. An examination lasts about 1/2 an hour and must follow a protocol for which we have developed a simplified index card based on the one proposed by HIRANO and B less. This simplified version has the advantage of being easily integrated into daily ENT practice. A visual examination of the larynx was carried out on 732 patients. Videostroboscopy was undertaken in 69.2% of cases and was found to be useful or essential in 68% of the cases where it was carried out. Furthermore, it enabled to correct a diagnosis in 13% of these cases. It was especially performed in the assessment of benign organic pathologies where associated pathologies have to be looked for (nodules--87.7%; REINKE's edema--72.2%; mucosal cysts--92.6%; sulcus and scars--83.3%), as well as for tumors (73.7%). Among the dysfunctional pathologies, it was principally carried in cases of hypokinetic dysphonia (87.7%). Videostroboscopy is a pertinent examination because, when it was used, it enabled to modify the initial diagnosis in 17% of dysfunctional dysphonias, 20% of nodules, 23% of REINKE's edemas and 17% of granulomas.