I was able to attend the 9th Congress of the European Laryngologic Society held in Helsinki, Finland June 13-16, 2012. Meeting Organizers Teemu Kinarai and Heikki Rihkanen.
It was an excellent Congress with a great many new ideas. Helsinki, Finland was completely blue and sunny for the three nearly 24 hour sunlit days of the conference. Some of the sessions that stood out in my mind:
Roland Rydell from Lund/Malmö, Sweden spoke about his diagnostic strategy for hoarseness. He has switched from laryngeal stroboscopy to entirely using high-speed video for diagnosis of laryngeal dysphonia. The advantage to this method for him is that he needs only to get a very brief recording of the vocal folds and because his recording is obtained at between 2000 and 4000 frames per second he will have a sufficient number of vibrations to review that he gets a detailed look at pathology. So, gaggy patients are not a huge problem. On the positive side, the ability to see the true mucosal wave along the length of the vocal cord helped greatly to isolate stiffer segments of the vocal cord. He also used videokymography to visualize these findings in another way that was very helpful for diagnosis. Speaking in the hallway to Felix de Jong, he seems to utilize videokymography in a similar way as his primary diagnostic method.
I was most intrigued by the views of diplophonia during conditions such as vocal fry where the two vocal cords continue to vibrate as mirror images of each other and yet each individual vocal cord is generating two frequencies simultaneously. He showed examples of this regularly irregular vibration with a skipped beat interval ranging from one 1-in-3 to 1-in-9.
On the negative side, Dr. Rydell’s endoscopic views seemed to be limited to a typical rigid endoscopic view from above, which might limit the information for lesions beneath the vibratory margin or for very small lesions or for lesions on the larynx, but not actually on the vibratory portion of the vocal cords. He also mentioned that the light is very bright and consequently heats the endoscope tip that is within the mouth and this could cause discomfort or a burn particularly in children.
Overall, it is an intriguing and apparently fruitful diagnostic way of examining hoarseness.
Two topics came up during the Human papilloma virus in the larynx series of lectures. One was that using Gardasil as an immunization in a patient who already had laryngeal papilloma virus seem to help the patient quell the viral papillomas. The second topic brought up which had seemingly no answer was whether family members of a patient who has learned a papilloma should consider the immunization.
Guillermo Campos showed excellent intralaryngeal rigid endoscopy with a 70° endoscope. He tipped the endoscope into the laryngeal introitus such that he could see into the laryngeal ventricles.
Meeting photos are at: http://www.flickr.com/photos/voicedoctor/sets/72157630148694142/