Diagnosis of Vocal Problems

About Dr. Reena Gupta

Dr. Reena Gupta is the Director of the Division of Voice and Laryngology at OHNI. Dr. Gupta has devoted her practice to the care of patients with voice problems. She is board certified in otolaryngology and laryngology and fellowship trained in laryngology, specializing in the care of the professional voice.

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Do I need anything more than a scope through my nose to figure out my voice problem?

Question: I recently went to an ENT because I was hoarse.  He put a scope through my nose and told me that I had a polyp on my vocal cord.  I wasn’t able to see what he was seeing, but he told me I needed surgery.  I am really nervous about having surgery and I didn’t get the feeling that I had a complete exam.  Is a scope in the nose good enough for a voice exam?


Flexible laryngoscopy (left) through the nose shows the larynx, but smaller and less-illuminated. Stroboscopy (right) involves the use of a bright strobe light under high magnification for a thorough voice examination.

Answer: The scope that goes in your nose (called a flexible laryngoscope) is not sufficient for a voice exam.

Stroboscopy is the gold standard for voice evaluation.  This high-tech machinery involves using high magnification and a voice-synchronized strobe light to allow the physician to view and analyze the vibration of the vocal cords. Stroboscopy allows a more magnified, high-definition view, with more illumination in order to correctly diagnose a voice problem.

Numerous patients have had polyps misdiagnosed and had incorrect surgery for treatment.  This occurs because unless the vibration is analyzed, which is impossible without stroboscopy, the risk of misdiagnosis is much higher.  Even the highest level of a flexible laryngoscope (called distal chip) cannot achieve what stroboscopy can.

The added benefit is that all stroboscopy enables recording, so the patient can better view and understand their problem.  This enables the patient to take more responsibility for their care, which always results in better outcomes.

 Key Points

  • A proper voice exam requires stroboscopy.
  • Strobosocpy is not available at every ENT’s office.
  • If you are having a voice problem, you should have stroboscopy to properly diagnose and treat your voice problem.


Flexible laryngoscopy (scope through the nose) versus Stroboscopy.  Note with stroboscoyp the image is brighter, more magnified, and the vibration of the vocal cord can be seen.

Read patient stories about Dr. Reena Gupta from The Division of Voice at the Osborne Head and Neck Institute.

To learn more about Dr. Reena Gupta, click here.