 The CAPE-V is used in a similar manner, rating of the dimensions of voice quality on a subjective scale from 0–100, and using this to determine an overall severity score.In the presence of neural lesions with unknown cause, a thorough ENT endoscopy with additional imaging techniques (computed tomography (CT) of the chest, particularly in the case of left-sided paralyses, and magnetic resonance imaging (MRI) of the neck including the base of the skull and the brain, ultrasound examination of the neck) are performed to exclude tumors along the laryngeal nerves.When tumor formation is suspected, parts of the hypopharynx and the upper esophagus and passive mobility of the arytenoid cartilage are endoscopically examined under anesthesia.