Diagnostic evaluation of the voice
A prerequisite for the safe course of any Voice Therapy and / or voice training program is the complete voice assessment. Before starting any voice rehabilitation program, an endoscopic video of the larynx is essential.
The Phoniatric assessment is performed by an E.N.T specialized in voice – that is, a trained Phoniatrist (the prefix “Phono” means “voice” in Greek). The examination is with stroboscopic laryngeal endoscopy, with both a rigid and flexible endoscope. Ideally, members of the Interdisciplinary Team complete with Voice Therapist and Voice Physiotherapist are also present during the diagnostic visit with the Phoniatrist, in order to jointly discuss the most ideal therapeutic plan for each case.
The Phoniatrist should provide each patient with a copy of the video of the endoscopic examination, so that the Voice Therapist can have the functional image of the larynx, in order to formulate the appropriate treatment program.
- Endoscopy with a rigid endoscope is optimal for:
- diagnosis of the histological condition and mobility of the true vocal folds
- the state of the superglottic and subglottic space
- the adequacy of the velopharyngeal sphincter.
Endoscopy with a flexible nasendoscope offers the Speech Therapist and the Surgeon an image of the functional state of the larynx during free speech and a specific vocal protocol, where we are interested in the following:
- symmetry, coordination and location of laryngeal structures
- the height of the larynx and the movement of the larynx on the vertical axis
- the coordinated adduction / abduction of the arytenoid cartilages
- movement of the tru vocal folds
- movement of false vocal folds
- mobility of the pharyngeal walls during voicing
- indications for G.E.R.D.
- state of hydration of the mucous membrane of the larynx
The Physician is responsible for all medical opinions, diagnosis, referrals and medication related to the patient’s voice difficulty.
The Voice Therapist is responsible for assessing the factors impacting on the functional behavior of the voice and determining the suitability of the person for voice rehabilitation or if further referrals need to be considered.