Expert Assessment and Treatment of Voice and Airway Disorders

Flexible fiberoptic videostroboscopy is a state-of-the-art test for assessing voice and airway complaints.

It provides an unparalleled view of the larynx and surrounding structures through a scope microprocessor with a distal chip camera.

“Videostroboscopy offers detail down to the level of the capillaries under the surface of the vocal cords, and it utilizes light filters that can pick up lesions not visible to the naked eye,” says Mausumi Syamal, MD, a laryngologist at LVPG Ear, Nose and Throat–Muhlenberg and Lehigh Valley Institute for Surgical Excellence. “Using a strobe light, it also provides information on vocal cord vibration over milliseconds.”

There is just one videostroboscopy machine in the Lehigh Valley, and it is located in Syamal’s office.

“Normally, videostroboscopy is available only in a high-level academic setting,” she says. “To be able to provide the highest level of laryngeal diagnostic imaging for our patients is really something special.”

Videostroboscopy is used to diagnose a wide range of voice and airway conditions, including:

• Vocal cord paresis, paralysis and fixation
• Tracheal and glottic stenosis
• Neurolaryngeal disorders
• Spasmodic voice disorders
• Laryngeal and airway papillomas
• Laryngeal and tracheal malignancies Acute, chronic and autoimmune laryngitis

The enhanced view that videostroboscopy affords can be crucial. For example, Syamal often sees individuals who have been diagnosed with asthma but failed to respond to standard treatments. Videostroboscopy sometimes reveals bilateral vocal cord paralysis or airway stenosis too small to be detected by a CT scan.

Once the underlying issue has been identified, the working channel of the scope may be used for specific therapeutic purposes, such as:

• Removal of foreign bodies
• Delivery of Botox injections
• Vocal cord augmentation
• Biopsy of certain laryngeal lesions

Syamal says that a videostroboscopy assessment should be considered for people who have:

• A voice complaint that has lasted longer than six weeks and is not improving with reasonable medical treatment and voice rest
• A breathing problem that is not improving with traditional assessments and therapies

“This is an indispensable tool for the accurate diagnosis of voice and airway problems,” she says.

In November, Lehigh Valley Hospital–Muhlenberg became the first hospital in the Lehigh Valley to offer ear, nose and throat procedures performed using the TruBlue laser system.

In the larynx and airway, this laser can be certain lesions, such as hemorrhagic polyps and laryngeal papillomas, as well as airway stenosis.

“The TruBlue laser is leading-edge technology,” Syamal says. “It is more precise and bloodless than older CO2 and KTP lasers.”