Physical examination

Abstract

Physical examination of the voice includes not just visualization of the larynx indirectly with a mirror; rather, the larynx and other areas of the body need to be assessed in a more sophisticated fashion. The vocal folds are evaluated using flexible laryngoscopes and magnified, rigid laryngeal telescopes, and using slow motion light (strobovideolaryngoscopy and high-speed video). This permits visualization of the complex and subtle movements of the mucosal wave of the vocal fold. Physical examination also needs to assess the support system (lungs, abdomen and back musculature, posture, and others) and the resonance system. Physical examination should include assessment of the patient during performance (singing, delivering a speech) in order to permit analysis of singing and speaking technique, and in order to hear the problem about which the patient has complained, especially if the patient is a singer or professional speaker. In addition, physical examination should include objective measures of voice and aerodynamic assessment.