Laryngoscopy

A laryngoscopy is a procedure done to get a closer look at the larynx and the structures near the larynx. It may be done in a doctor’s office with numbing spray in the throat, or in an outpatient setting under general anesthesia. A tube-like scope, called a laryngoscope, is inserted into your nose or mouth and then into your throat for viewing. Instruments with lighting and a camera are also used during the procedure.

Along with viewing, sometimes a piece of tissue is removed for examination in a lab (biopsy), or diseased tissue or foreign objects are removed. It’s typically considered a safe procedure, and side effects are rare.

These exams are usually done by an otolaryngologist (an ear, nose and throat specialist) or a head and neck surgeon.

What is your larynx?

The larynx is also called the voice box, because it contains vocal cords. The larynx is the section of your throat between the back of your tongue and trachea, or windpipe. Air passes into your larynx, goes through your vocal cords and down into your lungs. Your larynx is split into three sections:

• Upper part (supraglottis), which is above the vocal cords
• Middle part (glottis), where the vocal cords are located
• Lower part (subglottis), which is at the bottom between the vocal cords and trachea

Why is a laryngoscopy performed?

If you’re experiencing throat or voice problems, a laryngoscopy may help find the reason why. The procedure allows the doctor to see the tissues in and around your larynx more closely.

You might need a laryngoscopy to:

• Find the cause of a voice change or hoarseness
• Diagnose cancer of the larynx or areas of the throat near the larynx (hypopharynx)
• Take a biopsy
• Remove a vocal cord nodule or polyp
• Treat a laryngeal cancer with removal or laser surgery
• Find the cause of a cough or coughing up blood
• Find the cause of throat pain or pain felt in the neck or ear
• Find the cause of noisy or difficult breathing
• Find the cause of difficulty swallowing
• Diagnose a laryngeal injury
• Diagnose food or liquid going down into the windpipe (aspiration)
• Remove a foreign body

Types of laryngoscopy

There are three types of laryngoscopy:

Indirect laryngoscopy is an office exam done with a headlight and a mirror placed at the back of your tongue. Your doctor uses light from the headlight to reflect light from the mirror down into your larynx. This type is only used for examination, not for treatment.

Direct flexible laryngoscopy can also be done as an office procedure. A thin, flexible telescope is put down the back of your nose into your larynx. The scope may have a camera on the end. This type of laryngoscopy is usually used for diagnosing a problem, but may also be used to take a biopsy or remove a small growth (lesion).

Direct rigid laryngoscopy is done in the hospital outpatient setting under general anesthesia. During this procedure, a wider scope is placed through your mouth into the area above your larynx. During this procedure, a biopsy or surgical removal of a lesion can be done, or a foreign body may be removed.

You can discuss with your doctor why you need a laryngoscopy, which type and how it is done. Laryngoscopy is usually a safe procedure.

What happens before and during the procedure?

Preparation and what happens during the procedure depend on the type of laryngoscopy:

• Typically, no preparation before an indirect laryngoscopy is needed. During the procedure, your doctor may spray a numbing solution into the back of your throat to prevent gagging. During the exam, your doctor will hold the tip of your tongue with a gauze pad and place the mirror in the back of your throat. Your doctor may ask you to make sounds to check the movement of your vocal cords. There are typically no complications and no recovery period.


• Typically, no preparation before a flexible direct laryngoscopy is needed. Your doctor will put a spray into your nose to open up your nasal passage and numb the area. If a biopsy or a small lesion is removed, you may have a sore throat. Your doctor will provide instructions for care after the procedure.


• For a rigid laryngoscopy, you’ll need to prepare for general surgery by not having anything to eat or drink before the procedure. Your doctor will tell you when you need to start fasting. Make sure to let your doctor know about all the medications you take. You may need to stop some medications before surgery. During the procedure, while you’re asleep, a rigid scope will be placed into your throat. Your doctor will use long surgical instruments to take a biopsy, remove a growth or remove a foreign body. After you wake up from surgery, you’ll be observed until the anesthesia medications wear off. In most cases, this procedure is done as an outpatient, and you’ll go home with care instructions.

What happens after the procedure?

Unless there’s another reason you’re in the hospital, you should be able to go home after a laryngoscopy. If you have anesthesia for your laryngoscopy, ask someone available to drive you home.

Recovery depends on the type of laryngoscopy, but most people will recover quickly at home. Follow post-operative instructions, and keep all follow-up appointments.

Complications

There are generally no complications for an indirect laryngoscopy.

You may have some soreness in your nose or some bleeding from your nose after a flexible direct laryngoscopy, but this is rare.

Possible complications from a direct rigid laryngoscopy include:

• Reaction to anesthesia
• Bleeding
• Infection
• Sore throat
• Hoarseness
• Injury to the larynx or surrounding tissues

Understanding results

If a biopsy was taken, it may take a few days to get the results.

Results of a laryngoscopy depend on the reason for doing the procedure. If the laryngoscopy leads to a diagnosis of oral cancer or another condition, your doctor will discuss the findings with you.