Saturday, April 13, 2013

My Videostroboscopy

This past winter my outpatient facility was able to attain a pediatric flexible nasopharyngoscope through a grant! We wanted to test it out prior to a true patient coming for their evaluation. I volunteered to be the guinea pig!

What is a videostroboscopy? It is an evaluation of the structure and the movement of vocal folds. This evaluation can be preformed with either a ridged scope or a flexible scope. The first video you will see is with me and the flexible scope. With this assessment we (speech-language pathologists, the physician and/or ENT, and the patient) are able to collaborate and create an affective treatment plan pending on the results found.

What is the difference between videostroboscopy (video strobe) and a fiberoptic endoscopic evaluation of swallow (FEES)? Video strobes are utilized to assess vocal fold functions and integrity. FEES are used to assess swallowing. With FEES you utilize a flexible scope through the nose and then are able to view the patient as they swallow.

Today I thought it would be fun to just show the different videos I have - one with the flexible scope and one with the ridged scope. In another post I will talk about various pathological findings and common treatment plans associated.

Video 1: Flexible Scope



Quickly - you can see that I have a bit of swelling and a lot of redness. I had a cold at this time so it was interesting to see my right false vocal fold compensating a bit during adduction. 



Video 2: Ridged Scope


video


In this video you will see our two voice specialists that have both been trained in videostroboscopy evaluations. First, we have Missy handling the scope. As you can see the pro to using the ridged scope is that you have a much better picture but the con an increase chance of gagging. Carol decided to try it on herself to decrease the gagging.

The great part of video strobe and FEES is that you can really see how close the valleculae and pyriform sinuses are to the airway. Whenever I do a MBS my mind goes to this image especially in the case of residue on the aryepiglottic folds! I know that there are a lot of clinicians out there that have a preference of FEES over MBS or vise versa but I feel that both are wonderful tools and the knowledge gained from using both tools is invaluable to our patients! 


Here are just a few pictures for major anatomical markers that may be a nice reference while viewing the above videos.




Great resources:
http://www.texasvoicecenter.com/diseases.html

http://www.voicemedicine.com/reflux.htm#w

http://www.ent-stl.com/center-for-voice/frequently-asked-questions-about-videostroboscopy

http://www.google.com/imgres?q=aryepiglottic+fold&client=safari&sa=X&rls=en&biw=1535&bih=873&tbm=isch&tbnid=NPx05UR9eYJ85M:&imgrefurl=http://www.airwaycam.com/laryngeal-anatomy.html&docid=-Uo87U6dx8RN_M&imgurl=http://www.airwaycam.com/images/Oblique-Laryngeal-InletV3_01.gif&w=647&h=498&ei=hvJpUa6NAonHqQHZ_YDQAQ&zoom=1&ved=1t:3588,r:3,s:0,i:120&iact=rc&dur=7045&page=1&tbnh=177&tbnw=230&start=0&ndsp=31&tx=119&ty=79

http://www.google.com/imgres?q=aryepiglottic+fold&client=safari&sa=X&rls=en&biw=1535&bih=873&tbm=isch&tbnid=FcZIMU3g7Hv9bM:&imgrefurl=http://www.airwaycam.com/laryngeal-anatomy.html&docid=-Uo87U6dx8RN_M&imgurl=http://www.airwaycam.com/images/fairman-neck-lateral-color_02.gif&w=600&h=646&ei=hvJpUa6NAonHqQHZ_YDQAQ&zoom=1&ved=1t:3588,r:8,s:0,i:135&iact=rc&dur=411&page=1&tbnh=180&tbnw=167&start=0&ndsp=31&tx=24&ty=82

http://www.dukehealth.org/services/speech_and_audiology/care_guides/swallow_center/fiberoptic_endoscopic_evaluation_of_swallowing

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