What is
Laryngoscopy?
Laryngoscopy is examination of the larynx
(voice box) using either a small mirror held
against the back of your palate, or a
viewing tube called a laryngoscope.
Back to Top
Effects
of Laryngoscopy
using either indirect or direct laryngoscopy
helps a doctor:
·
Detect causes of voice problems, such as a breathy voice, hoarse
voice, weak voice, or no voice.
·
Discover causes of throat and ear pain.
·
Evaluate difficulty in swallowing, a persistent sensation of a
lump in the throat, or mucous with blood.
·
Detect injuries to the throat, narrowing of the throat
(strictures), or obstructions or masses in
the airway.
Direct rigid laryngoscopy may be used to
perform surgical procedures, including
removing foreign objects that may get caught
in the throat, collecting tissue samples (biopsy),
removing
polyps
from the vocal cords, or performing laser
treatment. Direct rigid laryngoscopy may
also be used to help diagnose cancer of the
voice box (larynx).
Back to Top
Candidates
for Laryngoscopy
Laryngoscopy is an examination a doctor uses
to look at the back of the throat, including
the
voice box
(larynx)
 and
vocal cords. If biopsy samples of suspicious
areas or growths are taken and sent to a
laboratory for analysis, it may take several
days for your doctor to receive the results.
|
Laryngoscopy |
|
Normal: |
A normal throat (larynx) shows no
evidence of inflammation, injury,
narrowing (strictures), or foreign
bodies. Your vocal cords show no
abnormal scar tissue, growths (tumours),
abnormal movement, or signs of
paralysis. |
|
Abnormal: |
There is evidence of inflammation,
injury, strictures, tumours, or
foreign bodies in the larynx. Your
vocal cords show signs of scar
tissue, abnormal movement, or signs
of paralysis. |
Direct rigid
laryngoscopy is usually recommended instead
of indirect laryngoscopy for:
-
Children.
-
People who
gag easily because of abnormalities in
their throat structure.
-
People who
may have symptoms of laryngeal or
pharyngeal disease.
-
People who
have not responded to previous
short-term therapy for laryngeal
symptoms.
Back to Top
Your
Consultation
Before a rigid laryngoscopy, tell your
doctor if you:
·
Are allergic to any medications, including anesthetics.
·
Are taking any medications.
·
Have any bleeding problems or take blood-thinning medications.
·
Are or might be pregnant.
You will also be asked to sign a consent
form. Talk to your health professional about
any concerns you have regarding the need for
the test, its risks, how it will be done, or
what the results will indicate. To help you
understand the importance of this test, fill
out the
medical test
information form
 (What
is a
PDF
document?).
Rigid laryngoscopy requires a
general
anesthetic. Do not eat or
drink for at least 6 to 8 hours before the
procedure. If you are scheduled to have this
test in your doctor's office or a hospital's
outpatient surgery centre, arrange to have
someone drive you home after the procedure.
The examination usually takes 15 to 30
minutes. You may be given an ice collar to
wear to reduce the risk of swelling in your
throat. After the procedure, you will be
watched closely for a few hours until you
are fully awake and able to swallow.
·
Do not eat or drink anything for about 2 hours or until you are
able to swallow without choking. After that
time, you may resume your normal diet,
starting with sips of water.
·
After the procedure, spit out your saliva. Do not swallow it.
-
Avoid clearing your throat or coughing
vigorously for several hours after the
procedure.
Back to Top
The Laryngoscopy
Procedure
Laryngoscopy is a procedure that a physician
uses to examine a patient's vocal chords to
see if they are functioning normally. It is
usually performed by one of two methods.
With direct laryngoscopy a thin flexible
tube containing fiber optics is inserted
into one of the patient's nostrils and is
then pushed forward and angled downward
towards the throat and vocal cords. The
physician is then able to look through an
eyepiece to directly examine the vocal cords
while the patient speaks. With indirect
laryngoscopy a small circular mirror on a
long thin handle is inserted into the
patient's mouth and turned so that the vocal
cords are reflected on the surface. The
physician is able to shine a bright light on
the mirror to examine the reflection of the
vocal cords while the patient speaks.
Indirect laryngoscopy
Indirect laryngoscopy is done in a doctor's
office using a small hand mirror held in the
mouth at the back of the throat, a head
mirror worn by the doctor, and a light
source. The mirror worn by the doctor
reflects light into the mouth. Some doctors
now use headgear equipped with a bright
light.
Indirect laryngoscopy has been largely
replaced by newer direct fibre-optic
laryngoscopic techniques that provide better
views and greater comfort during the
examination.
Direct fibre-optic (flexible or rigid) laryngoscopy
Direct laryngoscopy uses a fibre-optic scope
that allows the doctor to see deeper into
the throat than during indirect laryngoscopy.
The laryngoscope is either flexible or
rigid. Fibre-optic scopes provide better
views and are better tolerated than older,
rigid scopes. Rigid scopes are still used in
surgery.
Indirect laryngoscopy
You will sit straight up in a chair and
stick out your tongue as far as you can. The
doctor will hold your tongue down with some
gauze. This allows the doctor to see into
your throat more easily. If you gag easily,
the doctor may spray a
local
anesthetic into your throat
to numb the area.
The doctor will then hold a small mirror at
the back of your throat while wearing a head
mirror to reflect light into your mouth; or
the doctor may wear headgear with a bright
light to see into the back of your throat.
He or she may ask you to make a high-pitched
"e-e-e-e" sound or a low-pitched "a-a-a-a"
sound. Making these noises helps the doctor
see your vocal cords.
The entire examination takes only 5 to 10
minutes.
If a local (topical) anesthetic is used
during the examination, its effects will
last about 30 minutes. You can eat or drink
according to your doctor's instructions
after the anesthetic has worn off.
Direct flexible laryngoscopy
The doctor may also use a pencil-thin,
flexible fibre-optic instrument to look at
your throat. You will be given a medication
to dry up the secretions in your nose and
throat and allow the doctor to see more
clearly. A local anesthetic may be sprayed
on your throat to numb it.
The scope is put in your nose and then
threaded down your throat. As the scope is
passed down your throat, the doctor may
spray more anesthetic to keep your throat
numb during the examination. The doctor will
also swab or spray a medication inside your
nose that dilates your nasal passages to
provide a better view of your airway.
Direct rigid laryngoscopy
Before you have a rigid laryngoscopy, remove
all your jewellery, dentures, and
eyeglasses. You may want to empty your
bladder before the examination. You will be
given a hospital gown to wear.
Direct rigid laryngoscopy is done in an
operating room. A specially trained doctor
and several assistants will perform the
procedure. You will be given general
anesthetic to make you sleep through the
procedure. Since you will be given a general
anesthetic, you will need to fast for 6 to 8
hours before the examination.
You will lie on your back during this
procedure. An assistant will position your
head so that the laryngoscope can be easily
placed down your throat. After you are
asleep, the rigid laryngoscope will be
inserted through your mouth and down your
throat. Once the scope is in place, the
doctor will be able to view your voice box
(larynx).
The rigid laryngoscope may also be used to
remove foreign objects that may get caught
in your throat, collect tissue samples
(biopsy), remove growths from the vocal
cords, or perform laser treatment.
Back to Top
Recovery
In the recovery time after the procedure:
·
If your vocal cords were actually cut during the laryngoscopy,
rest your voice completely for at least 3
days after the procedure.
·
If you speak, do so in your normal tone of voice and keep your
conversations short. Whispering or shouting
can strain and damage the vocal cords as
they are trying to heal.
·
You may have hoarseness for up to 3 weeks after the procedure.
·
Resume your normal diet when you are comfortable doing so.
After the procedure, you may experience some
nausea, general muscle aches, and may feel
tired for 1 to 2 days. You also may have a
sore throat and some hoarseness for a few
days. Sucking on throat lozenges or gargling
with warm salt water may help soothe your
sore throat.
Back to Top
Risks
Laryngoscopy is usually a very safe
procedure. Although complications don't
occur very often, you should discuss the
risks in your particular case with your
doctor.
All types of laryngoscopy have a slight risk
of triggering a life-threatening blockage of
the airway. This risk may be greater if you
already have a partially blocked airway
because of tumours, polyps, or severe
inflammation of the tissues at the back of
the throat (epiglottitis).
If complete blockage of the airway should
occur, the doctor may have to make an
incision in your neck to help you breathe (a
tracheotomy). This complication is very
rare.
If biopsy samples were taken, there is a
very slight risk of prolonged bleeding,
infection, or perforation of the airway. In
very rare cases, death may occur from the
general anesthetic used during direct
laryngoscopy.
Back to Top
Frequently Asked
Questions
-
Back to Top |
