When the vocal folds (and larynx) are viewed in the office, by convention, the resultant image on the screen is usually* the mirror image of the way things actually are, with respect to the left and right sides. Conversely, in the operating room, during microlaryngeal surgery, the patient is placed on his or her back, laying on a table. As a result, the left hand side of an image generated by looking through a rigid laryngoscope now correlates with the patient’s left side.
One can think of the office image as being rotated 180 degrees from the view that is obtained in the operating room and vice versa.
I have chosen not to rotate the office images on this website primarily because:
- it will allow the reader to easily identify which images represent views in the operating room (“V” shape of the vocal cords is upside down)
- it will get your brain used to seeing vocal folds in the same way that you might see them in the office, should you have a laryngeal exam performed
- many of the published images of office-based laryngeal exams adhere to the above convention
* To make matters more confusing, some clinicians may hold their laryngoscopes “upside down” while examining larynges in the office, thereby producing an inverted V image of the vocal folds in the office. In this case, the left side of the image truly represents the patient’s left.
