We will perform a comprehensive evaluation to assess your voice use patterns -- how much you speak, sing, or use a loud voice, and what your voice sounds like. With vocal cord paralysis, your team is listening in particular for a weak, breathy voice, difficulty being loud, and getting tired with speaking. Your laryngologist will evaluate the role of any medical conditions that can cause voice changes, such as surgeries or recent illness. We will perform a head and neck examination and a visual examination of your voice box. Your team will also ask about difficulties swallowing. Further testing may be recommended.
This detailed visual exam helps us evaluate how your vocal cords vibrate while you make sounds. A tiny camera attached to a small tube called an endoscope is inserted through your nose and allows us to see your vocal cords and larynx (voice box). A flashing strobe light simulates slow-motion video images of your vocal cords. The exam takes only about a minute, and your nose may be sprayed with topical anesthetic for your comfort.
The exam allows us to look for any lesions, stiffness, paralysis, irregular movements, throat strain, or incomplete closure of the vocal cords. Videostroboscopy is often essential to reach an accurate diagnosis and determine the best treatment approach for you.
Computerized Acoustic Analysis
If voice therapy is recommended for you, this exam is completed at your second clinic visit. A visual display is created on a computer screen as you speak into a microphone. It allows you and your speech pathologist to see characteristics of your voice, including pitch, loudness, and vocal quality. It is used to identify abnormalities, including subtle vocal problems that cannot be detected with the unaided ear. It may be repeated during treatment to monitor your progress.
Laryngeal Electromyography (EMG)
May be used to evaluate your larynx nerves and muscles by analyzing their electrical activity. As you lie on your back, small, thin electrode needles are placed in the neck muscles that move your vocal cords. You may be asked to make sounds to activate each muscle being tested. Information about nerve damage can clarify whether a vocal cord paralysis may recover and provides information about voice changes from neurological conditions such as amyotrophic lateral sclerosis (ALS).