Functional Laryngoscopy
Speak and Swallow Speech Therapy are proud to offer Functional Laryngoscopy from a private, wheelchair accessible clinic in Burpengary East, Brisbane. This service is provided by experienced and suitably trained Speech Pathologists with an advanced scope of practice, under the guidance and care of medical professionals.
Why Functional Laryngoscopy?
A Functional Laryngoscopy is a type of instrumental assessment used to support diagnostic accuracy and enhance treatment planning for individuals with voice or breathing concerns. Within Speech Pathology scope of practice, the purpose of Functional Laryngoscopy is to:
• Assess laryngeal function in voice, breathing, and swallowing
• Conduct function voice assessment to determine functional voice use, constriction patterns, and the need for examination by an Ear, Nose and Throat Specialist (ENT)
• Assessment of the velopharyngal mechanism
• Assessment of vocal fold and supraglottic activity during respiration to screen for:
– dysfunctional breathing patterns
– persistent cough
– inducible laryngeal obstruction (ILO) with and without provocation
• Evaluate the effectiveness of interventions
• Screen for the need for further ENT examination
• Screening of reported pain or throat discomfort that may require further evaluation by an Ear Nose and Throat Specialist (ENT)
• Evaluate treatment outcomes
• Provide education to clients and carers regarding intervention
• Provide biofeedback during intervention programs
Signs and Symptoms of Laryngeal Dysfunction
- Hoarseness, strained, or changes in voice quality
- Difficulty speaking or projecting voice
- Reduced vocal range or pitch changes
- Vocal fatigue or loss of voice
- Coughing or throat clearing
- Chronic cough
- Breathing difficulties or shortness of breath
- Frequent throat infections or sore throat
- Loss of voice or voice fatigue after speaking for a short period of time
- Throat tightness or tension
- Pain or discomfort in the throat
- Feeling of something stuck in the throat
- Difficulty swallowing or a feeling of choking
What to Expect: Functional Laryngoscopy
During a Functional Laryngoscopy, a small tube, called a nasendoscope is placed in one nostril and directed to the back of your throat. From there, the Speech Pathologist can assess the function of your voice and breathing using a tiny camera on the nasendoscope connected to a monitor. This procedure takes approximately 20 minutes to complete.
This procedure is extremely safe and generally there are no complications. However, to ensure your safety, Speak and Swallow are supported by The Hub Medical Centre – located in the same precinct – to provide medical support if required during or after your Functional Laryngoscopy.
After your procedure, your Speech Pathologist will discuss your results and develop a management plan for you. This may involve a formal diagnosis and examination by a Respiratory Physician and/or an Ear Nose and Throat Specialist (ENT). Speak and Swallow work alongside Dr Elizabeth Hodge, based in Brisbane, and Dr Paul Paddle and Dr Anthony Rotman from Melbourne Swallow Analysis Centre to assist this process.
Functional Laryngoscopy procedures at Speak and Swallow will take place in a purpose-built clinic area, meeting infection control standards and fitted with specialised equipment. Speak and Swallow use the EndoCOMPACT Veezar System by XION, which is TGA approved and trusted by both ENTs and Speech Pathologists globally.
If required, swallowing function can be further investigated with a Flexible Endoscopic Evaluation of Swallowing procedure. This procedure is an extension of a Functional Laryngoscopy, involving trials of different food and drinks to instrumentally assess swallow function.
Speak and Swallow’s Functional Laryngoscopy service will not replace clinical assessments performed by Speech Pathologists. Similarly, it will not replace instrumental vocal tract examinations performed by medical professionals. The purpose of the procedure is not to diagnose laryngeal pathology, rather to assess function.
Contraindications:
Contraindications for Functional Laryngoscopy procedures may include:
- Severe agitation and reduced ability to cooperate
- History of vasovagal or fainting episodes
- Nasal trauma
- Recent treatment for head and neck cancer (including surgery, chemotherapy, and radiotherapy)
- Obstruction of both nasal passages
- Severe movement disorder
- History of severe epistaxis
- Where poor mucosal condition is suspected and nasendoscope insertion may cause further trauma
- Currently taking anticoagulation medication
- Base of skulls / facial fracture
- Unstable cardiac conditions
- Nasopharyngeal stenosis
- Sino-nasal anterior skull base surgery / tumours
Risks:
There are some known risks in the provision of Functional Laryngoscopy procedures. Speak and Swallow acknowledges these risks and has risk assessment processes in place to mitigate potential risks to client safety.
- Epistaxis (nose bleeding) Reported to occur in up to 1.2% of assessments.
- Laryngospasm (spasms of vocal folds which impact breathing) Reported to occur in up to 0.07% of assessments.
- Syncope collapse (including fainting, vasovagal syncope) Reported to occur in up to 0.1% of assessments.
- Person-to-person and environmental contamination
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