Flexible Fiberoptic Laryngoscopy

Flexible fiberoptic laryngoscopy is the most common examination used to view the throat and its surrounding structures. Performed endoscopically, it is performed to visualize abnormalities, biopsy tissue, or remove small growths, such as polyps, from the region. The flexible fiberoptic laryngoscopy enables the doctor to view the following areas: nasopharynx (back of the nose), oropharynx (back of the mouth), larynx (voice box) and hypopharynx (entrance to the swallowing passage).

Benefits of a Flexible Fiberoptic Laryngoscopy

One advantage of this type of laryngoscopy is that the flexible camera can be precisely manipulated, allowing the doctor a full view of the motion of the vocal cords. Another is that since the endoscope used in this procedure is made from thin, flexible fiberoptic cable, the patient experiences only minimal discomfort and requires no recovery time. Because the procedure is most often performed in the doctor's office, it is convenient and easy to schedule.

Reasons for a Flexible Fiberoptic Laryngoscopy

The flexible fiberoptic laryngoscopy may be performed to diagnose any of the following conditions:

  • Dysphagia, or swallowing difficulties
  • Vocal polyps
  • Vocal nodules
  • Laryngeal granuloma
  • Spasmodic dysphonia
  • Cancer of the larynx
  • Other problems with the voice box or throat

If the laryngoscopy is used as a diagnostic tool before another surgery, the doctor will instead perform a direct laryngoscopy as a suspension procedure which allows a hands-free view of the area.

The diagnosis of conditions in the voice box or larynx can be difficult since symptoms of varying disorders may be similar. For this reason, the diagnosis is typically made by a team that includes an otolaryngologist, a speech-language pathologist, and a neurologist or gastroenterologist so that all possible disorders are considered.

The Flexible Fiberoptic Laryngoscopy Procedure

First, the doctor applies a topical anesthetic to the back of the throat to ease any discomfort. The flexible laryngoscope is inserted into the patient's nose, moved into the throat and positioned near the affected area. During the procedure, the patient may feel a strange sensation of the scope through the nose, however he or she will be able to breathe normally.

The patient stays awake, giving the doctor a more accurate view of the vocal cords. During the laryngoscopy, the patient will be asked to make slow long vowel sounds, such as an 'ee' or 'ah', so that the movement of the vocal folds can be observed. The doctor may take photographs with a miniature camera attached to the end of the scope for further analysis. If necessary, the doctor may also take a tissue biopsy through the endoscope, using tiny surgical instruments.

The flexible fiberoptic laryngoscopy is a relatively painless procedure, lasting less than 30 minutes. After the procedure, the patient may have a sensation that the throat is swollen and may experience a bitter aftertaste, but these symptoms are short-lived. Once the examination is over, patients can immediately return to normal activities.

Risks of Flexible Fiberoptic Laryngoscopy

While this procedure is a very safe one, all types of laryngoscopy involve a minor risk of swelling or blockage of the airway. If the patient has a partial blockage due to polyps, tumors, or severe inflammation in the throat or larynx, there is a greater risk of these complications. Although rare, a complete blockage of the airway may require endotracheal intubation to assist with breathing. If a biopsy has been taken there is a slight risk of excessive bleeding, infection, or damage to adjacent tissues.

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