Modified Mallampati test (MMPG): The patient was in a sitting posture with the head in neutral position and was asked to open the mouth fully and protrude the tongue maximally without phonating
. Now the examiner observed the pharyngeal structures from front of the patient with pen torch and the view was graded as: I- Soft palate, uvula and pillars visible; II-Soft palate, uvula visible and pillars invisible; III--Soft palate and base of uvula visible; IV- Soft palate invisible.
The patient was instructed to perform a simple vocal cord exercise that involved taking a vital capacity breath and forcefully phonating
"eeeee" down to the residual volume.
When whispering was well established, she and the therapist practiced phonating
single words from a book.
While the patient is phonating
, approximately 2 to 3 ml of 4% lidocaine is delivered to the larynx through the side channel of the endoscope.
7A.) If an abnormality of the swallowing mechanism is suspected, AP and lateral views of the larynx and upper esophagus with the patient phonating
should be taken using a rapid filming device or video recorder.[3,11,16] Motion recording also can be used to assess esophageal motility.[16,28]
Relative voice rest means using the voice only when absolutely necessary and phonating
technically well while singing or speaking.