Stroboscopy Systems and Endoscopes Overview

Study Notes

Stroboscopy Systems

Stroboscopy systems can be purchased pre-assembled or assembled by the user.
Complete systems include light sources, endoscopes (rigid and flexible), camera, monitor, recording computer, microphone/electroglottograph for Fo, and a printer.
System components are customizable to meet user needs and budget.
Recording options include standard and high definition, real-time and playback.
Software for retrieving and viewing recorded examinations varies by system, and some allow remote access through the facility's network.

Endoscopes

Rigid Endoscopes

70-degree and 90-degree endoscopes are used for laryngeal imaging.
Rigid endoscopes offer higher resolution, brighter images, better contrast, and more accurate magnification compared to flexible endoscopes.
Examinations are typically straightforward and don't usually require topical anesthesia.
Smaller diameter (6mm outer diameter) endoscopes are available, improving examination tolerance for anxious patients.
A limitation is that only sustained vowels (e.g., "ee") can be evaluated, hindering the assessment of connected speech disorders.
Visualization with a 70-degree scope can potentially exaggerate glottal gap size and make arytenoid motion assessment difficult.
Technique: Patient sits slightly forward, with an extended neck and slightly protruded tongue. The examiner holds the tongue with gauze. The endoscope is inserted under the uvula or between the uvula and faucial pillars. The angle of the endoscope might need adjustment.
- 90-degree scopes are positioned to make light parallel to the vocal folds, utilizing wider viewing angles, requiring longer/zoom lenses for magnification.
Defogging: Defogging can be challenging. Defogging methods include liquid defoggers, warm water, soap film, surgical wax, or briefly touching the lens to the patient's cheek/tongue. Small amounts of benzocaine topical sprays aren't expected to affect outcomes.

Flexible Endoscopes

Flexible endoscopes allow dynamic visualization of the larynx during natural functions like speaking and singing.
They accurately assess arytenoid mobility, glottal gap, nasal cavity, and velopharyngeal port in one examination.
Preferred when movement is critical, not structure or mucosa health.
Useful for voice disorders like spasmodic and muscle-tension dysphonia.
Inferior light transport and magnification than rigid endoscopes. Distortion and moiré effects are possible, especially at image periphery.
Chip-tip endoscopes (with CCD cameras) reduce moiré and improve quality; newer highdefinition chip-tips are available.
Flexible endoscopes are more invasive for some patients, and carry risks of nosebleeds, anesthetic reactions, and vasovagal reactions; are available in various channel and distal tip diameters and working lengths, with and without working channel.
Technique: Topical anesthesia and vasoconstrictor are usually applied, and the scope is inserted through the nasal inferior or middle meatus (superior path is best for velopharyngeal examination). Raise the scope slightly while the patient swallows to avoid triggering a cough reflex.

Troubleshooting

High-quality examinations require appropriate focus, sufficient magnification for mucosal irregularities, and optimal brightness without obscuring details.
Contrast is important for differentiating lesions and vascular changes.
Ideal examinations include wide-angle laryngeal views and close-up vocal fold details.

Medical Records

Some systems have built-in databases for storing and retrieving laryngeal endoscopic/stroboscopic examinations.
Multiple stroboscopy units can be networked for remote video access.
Images/videos can be printed or saved electronically in reports.
Templates for reports (e.g., transnasal esophagoscopy, stroboscopy) are available.
Integration with electronic medical records is possible, using standards such as DICOM, and constantly evolving. The user should consider the integration possibilities when procuring new equipment.

Laryngeal High-Speed Videoendoscopy

Videostroboscopy is a common technique for evaluating vocal fold vibration, which works better with periodic vibration.
It's inadequate for assessing irregular vibration, which is common in disordered voice productions.
LHSV and high-speed kymography are higher resolution techniques, allowing observation regardless of phonatory duration or dysphonia severity. They capture images faster than vocal fold vibration rates.
- Kymography is a one-dimensional version of LHSV, showing single horizontal line movement, whereas LHSV allows viewing the entire vocal folds.
High-speed recordings, using increasingly advanced cameras, resolution, and computers, provide the groundwork for advanced techniques such as LHSV, which records images at 2000-10000+ fps, better overcoming the limitations of videostroboscopy's 25-30 fps. This technology improves observations of laryngeal function.

Description

This quiz explores the features and components of stroboscopy systems and the different types of endoscopes utilized for laryngeal imaging. Learn about the benefits of rigid versus flexible endoscopes, as well as customization options and recording capabilities of these systems. Test your knowledge on how these instruments enhance imaging accuracy and examination tolerance.

Stroboscopy Systems and Endoscopes Overview

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Questions and Answers

What is the main advantage of using rigid endoscopes compared to flexible ones?

Which aspect of the rigid endoscope examination is a significant limitation?

Which of the following elements is NOT a component of a complete stroboscopy system?

What is a characteristic feature of the laryngeal examination with a 70-degree rigid endoscope?

How do viewing options for recordings in stroboscopy systems typically vary?

Which attribute is NOT an advantage of a flexible endoscope compared to a rigid endoscope?

What is a drawback of using flexible endoscopes mentioned in the context?

Which method is primarily used for observing vocal fold vibration when conventional stroboscopy fails?

Which method of defogging endoscope lenses would likely damage the lens and risk patient safety?

What is a recommended practice during flexible endoscope insertion to avoid reflex actions?