Laryngoscopy

Definition

Laryngoscopy is a medical procedure which is used to obtain a clear view of the vocal folds and the glottis. This procedure is performed to facilitate tracheal intubation during general anesthesia, cardiopulmonary resuscitation or even for procedures on the larynx or other parts of the upper tracheobronchial tree.

In other words, this is an examination which lets the doctor to view the back of the throat, the voice box known as larynx, and also the vocal cords with a scope called laryngoscope.

Types of Laryngoscopy

1. Indirect laryngoscopy:-

This procedure is done using a small hand mirror which is held at the back of the throat. The doctor will shine a light into the mouth and wears a mirror on the head to reflect light to the back of the throat. Some doctors now use a headgear with a bright light.

This method is not used much now because the flexible laryngoscopes will let the doctor have a better view and also the patient will be more comfortable.

2. Direct flexible or rigid larynges:-

This procedure lets the doctor see deeper into the throat with a fiber-optic scope. This scope could be either flexible or rigid. Flexible show the throat better and are more comfortable for you. Rigid are often used during the surgery.

Why It Is Done

An indirect or direct laryngoscopy helps a doctor:

1. To find the cause of difficulty in swallowing or a lump in the throat, or mucus with blood in it.

2. To find the cause of voice problems, for example breathy or hoarse voice, voice or no voice.

3. To find the cause of pain in throat and ear.

4. Also to check any injuries in throat, narrowing of the throat or strictures or blockages in the airway.

Direct rigid laryngoscopy is a surgical procedure to remove foreign objects in the throat, to collect tissue samples known as biopsy, to remove polyps from the vocal cords and also to perform laser treatment. This procedure is also used to find cancer in the voice box which is also called larynx.

How It Is Done

Indirect laryngoscopy:-

You will have to sit straight in a chair and stick out your tongue as far you can. The doctor will hold your tongue down with gauze. This will help the doctor to see your throat even more clearly. If you gag easily, the doctor will spray a numbing medicine i.e. a local anesthetic into your throat which will help with the gaggy feeling.

Then the doctor will hold a small mirror at the back of the throat and shine light into your mouth. Along with, the doctor will wear a head mirror to reflect the light to the back of the throat. Instead the doctor can also wear headgear with a bright light hooked to it. Then the doctor will ask you to make a high-pitched "e-e-e" sound or a low-pitched "a-a-a" sound. Making of these sound, helps the doctor see your vocal cords.

The examination will take about 5 to 10 minutes.

If a topical or local anesthetic is used during the examination, it will last for about 30 minutes. You can eat or drink, once your throat is no longer numb.

Direct laryngoscopy:-

In this procedure, the doctor will use a thin and flexible Laryngoscope to look at your throat. You will be given a medicine to dry up the secretions in your nose and throat, which will help the doctor see even more clearly. A topical or local anesthetic is sprayed on the throat to numb it.

Then the scope is put inside your nose and is gently moved down into the throat. Once the scope reaches down your throat, the doctor will spray some more anesthetic to keep the throat numb during the examination. The doctor may also spray a medicine inside your nose which opens the nasal passage and gives a better view of your airway.

Risks

All types of laryngoscopy procedure will have a small risk of causing swelling and blocking the airway. If incase you had a partially blocked airway because of various reasons like tumors, polyps, or inflammation of the tissues at the back of the throat, you may have a higher chances of same problems.

In some rare cases, a complete blockage in the airway could occur, in such situation the doctor will have to put a tube inside the throat to help you breathe. Or, very rarely, the doctor will have to make a cut or incision in the neck which is known as tracheotomy.

If biopsy is taken, then there is a very small chance of infection or bleeding or a tear in the airway.

Results

If a biopsy was done, it may take several days for your doctor to know the results.

Normal result would be:-

The throat will not have swelling, an injury, narrowing or foreign bodies. The vocal cords will not have scar tissue, growths i.e. tumors or any signs of not moving correctly i.e. paralysis.

Abnormal result would be:-

Your larynx will have inflammation, injury, tumors or foreign bodies. Also the vocal cords will have a scar tissue or even signs of paralysis.