STROBOSCOPY

DR. SANJAY MAHARJAN

PG, ENT-HNS, MANIPAL
• Videostroboscopy has evolved as most practical and

useful technique for clinical evaluation of visco-elastic

properties of phonatory mucosa

• painless, office-based procedure

• essential evaluation of laryngeal mucosa, vocal fold

motion biomechanics, and mucosal vibration

• key elements for detecting and assessing pathology as

well as determining impact on voice and airway function

• Stroboscopy:

• Method used to visualize vocal fold vibration

• Uses synchronized, flashing light passed via flexible or rigid

telescope
• Flashes of light are synchronized to vocal fold vibration at
slightly slower speed, allowing examiner to observe it during
sound production in slow motion
• Information is essential for planning effective
phonomicrosurgery
• Provides useful, real-time information concerning nature of
vibration, image to detect vocal pathology, and permanent
video record of examination
• Improves sensitivity of subtle laryngeal diagnoses
• The Talbot law:

Images on human retina linger for 0.2 seconds after

exposure (persistence of vision)

• Concept of correspondence:

Interpretation of a corresponding portion of sequential

images representing an object in motion

• Strobolaryngoscopy takes advantage of these principles:

• producing intermittent light flashes in close relation to

frequency of vocal-fold vibration

• microphone picks up frequency of examinee's sustained

voice, which triggers stroboscopic light source.

• With provision that vocal vibrations are periodic, a

frequency of light flashes equal to vocal frequency

produces a clear, still image of same portion of vibratory
cycle.
• Instrumentation:

• A videostroboscopic unit consists

of

• stroboscopic light source and

microphone

• video camera

• rigid or flexible endoscopes

• video recorder. .
• Fundamental frequency

Measured by using strobe unit and is used to set frequency

of light flashes

• Amplitude:

• Lateral excursion of vocal folds during their displacement

away from midline during oscillation

• Highly dependent on pitch frequency and loudness

• Generally graded as normal, less or greater than normal

• Symmetry:

• Normal motion of arytenoid cartilages is assessed during flexible

or rigid telescopic laryngoscopy and vibratory characteristics of
phonatory mucosa are assessed during stroboscopy.

• Glottic closure:

• In a healthy person musculomembranous portion of vocal folds

completely closes during vibratory cycle.

• Mucosal wave:

• reflects rheological properties of phonatory mucosa during a

specific vocal task.
• Periodicity:

• Regularity of successive vocal vibratory cycles

• Normal vibratory activity is regular and periodic.

• Diagnostic Findings:

• Vocal fold cysts

region of cyst demonstrates diminished pliability

exact characteristics of mucosal-wave deficit depend on size

and location of cyst.

• Vocal fold polyps

vibratory patterns of 2 vocal folds are asymmetric, with

diminution of vibration near lesion
• Vocal fold nodules

Glottic closure is compromised, esp. in high pitch frequencies

Mucosal wave is usually preserved bilaterally, but pliability and

amplitude of excursion are decreased in region of nodule

• Sulcus vocalis

refers to a spectrum of phonatory mucosal vibratory deficits in

which stroboscopic findings demonstrate zones of diminished

mucosal pliability