Unfortunately the vocal chords are "well hidden" and it takes the knowledge and experience of the ENT specialist to examine them and, thanks to the appropriate equipment in the office, to enable the patient to "gaze" at his vocal chords on video. The examination is much more harmless than it may appear to a layman.

With a laryngoscopy the patient should stick out their? tongue and try to say 'e'. That doesn't sound much like an 'e' with an open mouth, but the larynx moves to the position in which the vocal chords can be observed by placing a mirror just before the soft palate (roof of the mouth).

With a microlaryngoscopy an endoscope is used instead of the mirror. With the help of the flexible endoscopy, I am able to examine patients whose gagging reflex is so severe that they even have problems brushing their teeth and for whom every visit to the dentist fills them with dread. These patients "love" this for the more comfortable examination of the larynx via the nose, which is, of course, desensitised by the use of a spray in advance.

A Stroboscopy uses a trick (light is flashed at certain frequencies while the vocal chords are in motion, creating an image of a static or slow-motion vocal chord) to make things visible which would remain hidden with a normal examination (such as very small swellings or changes on the underside of the vocal chords or malfunctions). With a Video Stroboscopy, a camera is mounted on to the end of an endoscope and the examination is recorded on video. This has the advantage that changes which are only visible for a fraction of a second can be analysed at length - also a still frame - shown and explained to the patient and then saved onto computer.

With this technology it is possible to assess any changes more accurately over the years and I always take the opportunity to document the "normal condition" of a patient, whether he is healthy at the end of a routine check up or at the end of a course of treatment.