Laryngoscopy

Definition

Laryngoscopy is an exam of the voice box and vocal cords. It can be done as:

  • Indirect—uses mirrors to check the larynx and hypopharynx, an area that leads to the lungs and stomach
  • Direct—uses a special instrument, most often a flexible scope

The Larynx

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Reasons for Procedure    TOP

Laryngoscopy is used to check for and diagnose problems inside the throat. It is most often done to:

  • Help with placing a breathing tube—used with breathing problems during surgery or with serious illness
  • Find the cause of a lasting cough, bloody cough, hoarseness, throat pain, or bad breath
  • Look for causes of breathing or speaking problems
  • Look for a cause for repeated earaches
  • Remove something from your throat that was swallowed by accident
  • See a mass in the throat
  • Take tissue samples from inside the throat—biopsy
  • Remove polyps inside the throat

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems such as:

  • Pain
  • Vomiting and gagging
  • Swelling
  • Bleeding
  • Cuts on the bottom of the tongue from stretching it over the teeth
  • Nosebleeds if the scope is passed through the nose
  • Reaction from anesthesia
  • Breathing problems from swelling
  • Infection

What to Expect    TOP

Prior to Procedure

You may have a physical exam and a:

Leading up to your procedure:

  • Arrange for a ride to the care center and back.
  • Don’t eat or drink anything for 8 hours in advance. If you’re going to an office, you don’t need to fast.
  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to 1 week in advance.

Anesthesia

Local or general anesthesia may be used for a laryngoscopy. Local anesthesia will numb the throat. With general anesthesia, you will be asleep.

Description of the Procedure    TOP

Images may be taken during either type.

Indirect Laryngoscopy

You will sit up straight in a high-back chair. A headrest will push your head and jaw forward. The anesthesia will be sprayed into your throat. Your tongue will be covered with gauze and held by the doctor. You will then need to breathe through your mouth as if panting. A warm mirror will be held at the back of the throat. The doctor will ask you to make a certain sound and watch the larynx. If there is a foreign object, such as a chicken bone, it can be removed.

Direct Fiberoptic Laryngoscopy

The direct method is most often done after the indirect method. It allows the doctor to see a greater area. It may also be used if your gag reflex didn't allow a thorough exam. A special scope will be placed through your nose or mouth, then into your throat. The larynx will be checked through an eyepiece on the scope or a camera. The doctor take samples, remove growths, or take out a foreign object trapped in the throat. This method under general anesthesia or in the office under local anesthesia.

How Long Will It Take?    TOP

The indirect method only takes a few minutes. The direct method takes about 5–45 minutes, depending on the problem.

Will It Hurt?    TOP

Anesthesia will prevent pain during the procedure. With a direct method, you may have a sore throat for a few days if a biopsy was done.

Postoperative Care    TOP

If any tissue was removed, it will be check in a lab.

You may need to avoid clearing your throat or coughing if you had a biopsy.

Call Your Doctor    TOP

Call your doctor if any of the following occur:

  • Increasing pain
  • Coughing up, spitting out, or vomiting blood
  • Breathing or swallowing problems
  • Signs of infection such as fever or chills
  • Hoarse voice
  • Nausea or vomiting

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Academy of Otolaryngology—Head and Neck Surgery
https://www.entnet.org
American Cancer Society
https://www.cancer.org

CANADIAN RESOURCES:

Canadian Digestive Health Foundation
http://www.cdhf.ca

References:

Laryngoscopy. Kids Health—Nemours Foundation website. Available at: https://kidshealth.org/en/parents/laryngoscopy.html. Updated April 2016. Accessed August 10, 2018.
Laryngoscopy and biopsy. NetDoctor website. Available at: https://www.netdoctor.co.uk/procedures/surgical/a4655/laryngoscopy-and-biopsy/. Updated May 7, 2009. Accessed August 10, 2018.
Last reviewed June 2018 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 8/10/2018

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