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Laryngoscopy

Laryngoscopy is a procedure that allows a surgeon to look at the back of your nose, throat and voice box (larynx). You will meet the surgeon carrying out your procedure to discuss your care. It might be different from what we’ve described here because it will be designed to meet your individual needs.

Laryngoscopy helps your surgeon to find out the cause of voice problems, swallowing difficulties, and throat or ear pain. It can also be used to check for injuries to your throat, narrowing of your throat (strictures), or blockages in your airway.

Laryngoscopy can be done in two ways.

  • Flexible laryngoscopy uses a thin, flexible, fibre-optic tube with a light and a camera lens at the end called a laryngoscope. Your surgeon passes the laryngoscope through your nose to the back of your mouth. It’s used for check-ups and to make a diagnosis.
  • Rigid laryngoscopy uses specially designed tubes that your surgeon passes through your mouth. Instruments can then be passed through the tubes to remove any blockages in your throat. Or it might be used to take a tissue sample (biopsy), remove polyps (growths) from your vocal cords or to carry out laser treatment.

Both flexible and rigid laryngoscopy procedures are usually performed by an ear, nose and throat (ENT) surgeon.

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Details

  • Preparation Preparing for a laryngoscopy

    Your surgeon will spend some time explaining how to prepare for your procedure.

    Flexible laryngoscopy is done as an outpatient procedure under local anaesthesia. You will usually have the local anaesthetic as a nasal spray. This will reduce the sensation of the laryngoscope passing through your nose and help to decongest your nose.

    Rigid laryngoscopy is done as a day case procedure under general anaesthesia, which means you will be asleep during the procedure.

    If you’re having a general anaesthetic, it’s important to follow your surgeon’s advice. You will be asked not to eat or drink for about six hours beforehand. And your nurse may check your heart rate and blood pressure when you’re at the hospital.

    When you’re having rigid laryngoscopy, there will be some pressure on your top teeth from the laryngoscope. You may be given a gum shield to use to protect your teeth during the procedure. If you have healthy teeth this won’t usually cause a problem. It‘s important to let your surgeon know if you have implants, caps, crowns or any other dental work.

    Your surgeon will have a chat with you about your procedure and any pain you might have. This is a great opportunity to ask questions so you fully understand what’s going to happen. You’ll be asked to give your consent for the procedure to go ahead by signing a consent form.

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  • The procedure What happens during a laryngoscopy?

    Flexible laryngoscopy

    This procedure usually takes about 10 minutes and you will need to be in a seated position. Your surgeon will spray the local anaesthetic into your nose. It has an unpleasant taste, may make you cough and will make your throat feel different to normal. The numbing effect lasts for about an hour.

    Your surgeon will then pass the laryngoscope through your nose and into the back of your mouth. To allow your surgeon to see your entire throat, you may be asked to:

    • stick your tongue out
    • take some deep breaths
    • talk and puff out your cheeks

    A camera lens on the end of the laryngoscope can be used to send pictures from the inside of your throat to a screen.
     

    Rigid laryngoscopy

    This procedure usually takes about 30 minutes and you will need to be lying on your back. Before you lie down, you’ll be asked to remove any dentures or dental plates, contact lenses, glasses and jewellery. Once the general anaesthetic has taken effect, your surgeon will carefully pass the laryngoscope down your throat. They may look directly into the laryngoscope or at images on a screen.

    If necessary, your surgeon will take a biopsy. This is done using special instruments that are passed through the laryngoscope. The biopsy is sent to a laboratory for testing. This is to determine the type of cells and whether these are benign (not cancerous) or malignant (cancerous).

  • Aftercare What to expect afterwards

    If you have general anaesthesia, you will need to rest until the effects of the anaesthetic have passed. You will probably be able to go home when you feel ready. You should arrange for someone to drive you home and have a friend or relative stay with you for the first 24 hours.

    If you have a local anaesthetic, it may take around an hour before the feeling comes back into your throat. You shouldn't drink hot drinks until the local anaesthetic has worn off because you won’t be able to feel how hot they are.

    If you have a biopsy, your results will be ready several days later and will usually be sent to the surgeon who recommended the laryngoscopy. At the hospital, your surgeon may discuss other findings from the laryngoscopy with you before you leave. Or you may be given a date for a follow-up appointment.

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  • Recovery Recovering from a laryngoscopy

    You're likely to have a sore throat after the laryngoscopy. This can last for a few days after a rigid laryngoscopy. If you need pain relief, you can take over-the-counter medicines, such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    General anaesthesia temporarily affects your coordination and reasoning skills, so don’t drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, follow your surgeon's advice and contact your motor insurer so that you're aware of their recommendations.

    Most people don’t have any problems after a laryngoscopy, but you should seek urgent medical attention if you:

    • cough up or vomit blood
    • have difficulty breathing
    • develop a high temperature
  • Risks What are the risks?

    As with every procedure, there are some risks associated with laryngoscopy. We haven’t included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

    Side-effects

    These are the unwanted but mostly temporary effects of a procedure, for example, feeling sick as a result of the general anaesthetic.

    Side-effects of a laryngoscopy may include:

    • a sore throat
    • changes to your voice, especially if your surgeon takes a biopsy
    • a stiff neck
    • bleeding from the biopsy site – you may see small amounts of blood in your sputum (phlegm)
    • nosebleed

    Complications

    This is when problems occur during or after the procedure. Most people aren’t affected.

    Complications of a laryngoscopy can include:

    • difficulty breathing – this can be caused by having the laryngoscope in your throat or because of the effects of the general anaesthesia
    • reaction to the general anaesthesia
    • damage to your airway or throat lining – particularly if you have a biopsy taken
    • damage to your teeth – this can happen as a rigid laryngoscope is passed through your mouth
  • FAQs FAQs

    How soon after a laryngoscopy can I eat or drink?

    Answer

    You should be able to eat and drink as soon as you feel ready and the numbness caused by any local anaesthetic has worn off.

    Explanation

    After having a laryngoscopy, you may have a sore throat for a few hours afterwards. You may want to eat soft foods or liquids until you feel better.

    If you’ve had a local anaesthetic, wait until this has worn off before eating. This usually takes about an hour.

    If you’ve had biopsies taken, your surgeon may ask you to not eat or drink anything for a few hours after your procedure. After that they will probably recommend that you start with water for two to four hours before starting your normal diet.

    Speak to your surgeon if you need advice about eating and drinking after your procedure.

    Will having a laryngoscopy affect my voice?

    Answer

    Your voice may be hoarse for a short while after the procedure. It's unlikely to have any long-term effects on your voice unless you have a medical problem that affects your voice box (larynx).

    Explanation

    Your voice is made of tones produced by your larynx. The different sounds you make are formed by your tongue, teeth, lips and nose. Immediately after a laryngoscopy, especially if you had biopsies taken, you may have some swelling in your throat. This can affect the quality of your voice. Your voice may sound hoarse or you may find you completely lose your voice until the swelling goes down.

    Your surgeon may suggest you rest your voice after laryngoscopy.

    If you have a medical condition affecting your larynx, it's possible you may have long-term problems with your voice.

    Ask your surgeon to explain the specific risks of the laryngoscopy procedure and how these risks apply to you.

    What is an ear, nose and throat (ENT) surgeon?

    Answer

    An ENT surgeon is trained in the surgical and medical treatment of conditions affecting the ears, nose, throat, head and neck.

    Explanation

    ENT surgeons manage problems with hearing and balance, sinus infections, snoring and voice and swallowing disorders. They also deal with throat and neck cancers.

    ENT surgeons are usually called Mr or Mrs rather than Dr and will have Fellow of the Royal College of Surgeons (FRCS) after his or her name. The Royal College of Surgeons is responsible for the training and examination of surgeons, and supports surgical research in the UK.

    If you think you need advice or treatment from an ENT surgeon, contact your GP. They will be able to recommend a reputable surgeon and give advice about how to choose where to be treated.

  • Resources Resources

    Further information

    Sources

    • Holsinger FC, Kies MS. Examination of the larynx and pharynx. N Engl J Med 2008; 358: e2. doi: 10.1056/NEJMvcm0706392 
    • Video laryngoscopy and fiberoptic assisted tracheal intubation. Medscape. www.emedicine.medscape.com, published 26 December 2013
    • Microlaryngoscopy. ENT UK. www.entuk.org, accessed 19 March 2014
    • Vocal polyps and nodules. Medscape. www.emedicine.medscape.com, published 19 September 2013
    • Tests for cancer of the larynx. Cancer Research UK. www.cancerresearchuk.org, published 22 August 2013
    • Laryngeal cancer. PatientPlus. www.patient.co.uk/patientplus.asp, published 18 March 2011
    • Koeppen BM, Stanton BA. Berne & Levy Physiology. 6th ed. Philadelphia: Mosby; 2010 
    • Hoarseness. PatientPlus. www.patient.co.uk/patientplus.asp, published 18 March 2011
    • Personal communication. Mr Anil Banerjee, Consultant Otolaryngologist, Spire Hospital Leicester, 15 June 2014
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