Inclusion Criteria:  Adult patients (18 or older) Patients scheduled IOLP at our Voice Institute, including laryngeal biopsies, percutaneous injection laryngoplasty, KTP ablation of hemorrhagic polyps and respiratory papilloma, and transnasal esophagoscopy (TNE).  Exclusion Criteria:  Patients under 18 years of age Patients unable to consent Non-English-speaking patients Patients who have undergone prior IOLP Patients who have used any psychotropic or analgesic medication within the last 24 hours due to the possible confounding effect on pain or anxiety perception Patients with motion sickness or uncorrected visual impairment (legal blindness) Patients with past medical history of seizures or visual abnormalities