Videostroboscopy and high-speed imaging is now an accepted way to evaluate laryngeal function in patients with voice disorders. In patients with neurolaryngological diseases such as tremor, laryngeal spasm, and paralysis, having an objective way to evaluate vocal function is desirable. Using digital imaging and analysis, both the videostroboscopy and the high-speed video can be analyzed to obtain relevant measures of vocal function. From the videostroboscopy, the montage of the glottal cycle derived from steady of vocal vibration can be analyzed by using edge tracking software to obtain the glottal area waveform. The waveform is an indication of the efficiency of the vocal folds in acting as an oscillator and gives direct information as to the open and closed phase, the symmetry of vocal fold vibration and the degree of amplitude contribution from each fold. High-speed video overcomes the deficiencies of stroboscopy by allowing for all voice gestures to be studies. Using digital kymography and analysis of the vibrogram, analysis of the onset of vocal fold oscillation, evaluation of diplophonia, tremor, and voice breaks becomes possible. Furthermore, analysis of the high-speed video kymograph tracing using signal analysis allow the investigator to evaluate the frequency and power relationships of vocal fold vibratory function in the normal and disordered state.Laryngeal electromyography (LEMG) is an important diagnostic and prognostic tool in neurolaryngology. This chapter presents the advances in LEMG in the last 5 years based on clinical trials. LEMG is in most cases an office-based procedure for decision making in neurolaryngology. When performed in a standardized way, LEMG helps to differentiate abnormal function of the vocal folds from nonorganic disorders. It is mainly used to confirm the diagnosis of vocal fold paralysis (VFP) and is less frequently used for the diagnosis of myopathies and motor neuron disorders. Also, Raltitrexed supplier of LEMG for other diseases than VFP is presented. First consensus recommendations for standard performance of LEMG have been published. #link# This will facilitate the comparison of results from different researchers in the future. For many years, LEMG focused on the thyroarytenoid muscle. Data are presented showing that now more and more studies are performed including other laryngeal muscles, most importantly the posterior cricoarytenoid muscle and cricothyroid muscle. Diagnostics and estimating the prognosis for patients with VFP remains the most important issue for LEMG. First meta-analyses are now available analyzing which LEMG parameters are the best prognosticators for recovery or persistent palsy. Due to the advances in multichannel LEMG, laryngeal nerve monitoring can now control the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve during thyroid surgery. Finally, also the advances of LEMG for laryngeal pacing, guided laryngeal injections, laryngeal electrostimulation, and other indications beyond otolaryngology are discussed.Visual diagnosis of laryngeal neurologic impairments is not only possible but is perhaps the most accurate method for evaluating the neurologic status of the upper airway. Precise assessments may lead to appropriate treatment without an EMG study. Principles of the neurolaryngology examination include (1) each muscle has a single action; (2) that action can be elicited and to some degree isolated and visualized; (3) each muscle has an appropriate time to contract; (4) that timing can be compared to the opposite side; (5) inappropriate timing represents reinnervation; (6) inappropriate degree of motion represents reinnervation; (7) patients naturally compensate for any loss; (8) removing compensation during an exam reveals pathology. Some of the visual diagnostic findings available to the astute endoscopic examiner are (1) paralysis, (2) paresis, (3) synkinesis, (4) fixation, (5) tremor, (6) spasm, and (7) reinnervation.In the setting of a voice clinic, the voice may be assessed in a number of different ways. As a bare minimum, assessment should include stroboscopic examination, patient self-reported questionnaires, and clinician-reported perceptual evaluation. In addition, recordings of the voice may be analyzed using computer software several different measures exist, but the most widely used are jitter, shimmer, and noise-to-harmonic ratio. There are, however, significant limitations of these measures, including access to the equipment, inter-test reliability of the measurements, and a lack of correlation with clinical improvement. Other mathematical techniques (nonlinear algorithms) may provide more robust measurements. A pragmatic approach to assessment in the voice clinic suggests that stroboscopic examination should be accompanied by patient-reported questionnaires and clinician-rated voice assessments.The role of imaging in assessment of neurolaryngology will predominantly involve the assessment of pathology along that of laryngeal nerve pathways. The anatomical pathways of the vagus and laryngeal nerves are well described in standard anatomical textbooks and will not be detailed here. Whilst there are 3 principle laryngeal nerves/branches, the recurrent laryngeal nerve will clearly constitute the mainstay of imaging input. This chapter will elaborate on the pathology encountered at the various levels and the imaging characteristics of these disorders. Prior to this, there will be a summary of normal laryngeal imaging appearances to familiarise with the characteristics of radiological anatomy.The history of research on the voice of opera soloists shows that there are certain functional features of the cranial nerves and cortical nerve centers. In this chapter, we review the most important findings in the field of canto voice neuroanatomy, which we corroborate with the results of our team research and experience. Our study focuses on the nerve structures involved in phonation at each level of the vocal formants infraglottic, glottic, and oropharyngeal. We consider this research to have direct applicability in the fields of neurolaryngology, neuroscience, phoniatry, but also in the academic teaching. At the same time, the present study is a starting point for future research works on the anatomical and functional particularities of the structures involved during the act of phonation in canto soloists.