A laryngoscopy is a diagnostic and treatment procedure that examines the larynx, or voice box, which contains the vocal cords. This procedure can be performed for many reasons, including to diagnose a persistent cough, hoarseness or bad breath, to detect a mass or tumor on the vocal cords, or to treat conditions of the throat and larynx. During the procedure, the physician is able to see the voice box and vocal cords with clarity because they are magnified and illuminated. Videos are produced during the examination and can be reviewed immediately afterwards. In most cases, the laryngoscopy can be performed outpatient with very little necessary recovery time.
Reasons for a Laryngoscopy
A laryngoscopy may be performed for a number of diagnostic or treatment purposes. One of the advantages of a laryngoscopy is that treatment opportunities are available during the procedure if abnormalities are discovered. If polyps are found during the endoscopic examination of the larynx, for example, they can be removed immediately.
A laryngoscopy may be used to diagnose the reasons for any of the following:
- Chronic bad breath
- Respiratory problems, noisy breathing (stridor)
- Coughing up blood
- Swallowing difficulties
- Chronic ear pain, sore throat or cough
- Ongoing voice problems, such as hoarseness or laryngitis
- Sensation of throat blockage
- Throat inflammation
- Acid reflux
- Presbylaryngitis, atrophy of the vocal cords
As a treatment method, a laryngoscopy may also be performed to:
- Remove vocal polyps, nodules or cancerous growths
- Biopsy tissue
- Administer laser therapy
- Remove foreign objects
- Perform other surgery of the throat or larynx
- Treat spasmodic dysphonia
There are three types of laryngoscopy: direct, indirect, and fiberoptic. The type of laryngoscopy performed depends on the reasons for the procedure.
During this procedure, the most common of the three, a local anesthetic is sprayed into the nose to numb the area and a flexible fiberoptic laryngoscope is passed through the nose into the throat. This type of laryngoscopy only takes a minute or two and is performed in the doctor's office. The patient is awake for the procedure.
During an indirect laryngoscopy the doctor holds a small mirror at the back of the throat while shining a light into the area. Like the fiberoptic laryngoscopy, this is a quick procedure, most often performed in the doctor's office while the patient is awake. Local anesthetic is sprayed into the throat to prevent discomfort.
A direct laryngoscopy, is performed in a medical facility when a biopsy of tissue is required or when removal of a foreign object is necessary. A direct laryngoscopy makes it possible for the doctor to visualize and reach the deepest area of the throat. For this procedure either a stiff or flexible laryngoscope is used while the patient is under general anesthesia. This type of laryngoscopy takes about 30 minutes and requires a bit more recovery time than the other two.
Laryngoscopies are frequently performed as suspension procedures which permit the doctor a hands-free view of the throat.
A laryngoscopy is minimally invasive and relatively easy to recover from. Patients will sometimes experience soreness in the throat after the procedure for which they may be given throat lozenges, pain medications or ice packs to reduce inflammation. Patients often have temporary problems with swallowing after a direct laryngoscopy and will have to refrain from eating or drinking for a few hours because there is a danger of choking. It is possible that a patient may require further treatment after a laryngoscopy which may include further surgical intervention, treatment with medication, or voice therapy.
Risks of the Laryngoscopy
While a laryngoscopy is generally a very safe procedure, because it involves the airways there is a risk of breathing difficulties. Patients are carefully monitored to make sure their respiration is normal. In cases where inflammation causes a blockage, a temporary tracheotomy can be performed if necessary. As with any surgical procedure, risks of the following exist:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medications
- Post-surgical infection