The listening exam is the second part of the three-part voice examination. By listening systematically to pitch, volume, noise, and signal characteristics — before placing the scope — the examiner predicts the pathology and knows exactly where to look.
◆ Pitch & Volume
Listening to pitch and volume together — the laryngogram concept — reveals patterns of impairment that a single perceptual scale cannot capture. The shape of a patient’s vocal range map predicts the underlying pathology before the scope is placed.
◆ Vocal Capabilities Testing
A structured sequence of vocal tasks — anchor pitch, maximum phonation time, pitch range, loudness range, swelling tests, vegetative sounds, and neurologic probes — converts a brief vocal performance into a diagnostic map of what the cords can and cannot do.
◆ Vocal Findings — Noise
Air leak, polyphonia, diplophonia, and flutter each represent a distinct disruption of the glottal signal. Case studies show how noise in the sound tells the examiner where closure is failing — before the scope is placed.
◆ Vocal Findings — Altered Signal
Onset delays, pitch breaks, tremor, spasm, and inspiratory stridor each represent a disruption in the timing or control of the vocal signal. The shape of the abnormality points to the neurological or mechanical cause.