Laryngoscopy

Laryngoscopy is a procedure that lets the doctor look at the back of the throat, the voice box (also called the larynx) and the vocal cords.

You may have a laryngoscopy if you have:

• throat or ear pain that doesn’t go away
• voice problems, such as a hoarse voice, a weak voice or no voice at all
• trouble swallowing
• breathing problems
• a cough that won’t go away
• a lump in the head or neck area
• bad breath that won’t go away

A laryngoscopy can also be used to:

• check the throat for redness or swelling or for a blockage
• remove something that is stuck in the throat
• take a sample of tissue from the throat or vocal cords so that it can be looked at under a microscope (called a biopsy)

Most laryngoscopies are done by an otolaryngologist, which is an ear, nose and throat (ENT) doctor. Other doctors may also do them.

Your doctor will tell you if you need to do anything to prepare for the type of laryngoscopy you’re having. You may need to avoid eating or drinking before the test to prevent vomiting. If you wear dentures, you will need to take them out before the test.

Indirect laryngoscopy is usually done in a doctor’s office. You can have anesthetic sprayed onto the throat to numb it and help prevent gagging during the test. The numbing usually lasts about 30 minutes.

You will sit in a chair and be asked to stick out your tongue as far as you can. Your tongue will be held down with some gauze during the test. To look at the throat, larynx and vocal cords, the doctor wears a head mirror with a bright light hooked to it and holds a small mirror at the back of the throat.

You may be asked to make certain sounds to help the doctor see the vocal cords.

Direct flexible laryngoscopy is usually done in a doctor’s office. It’s sometimes called a fibre optic laryngoscopy. You can have anesthetic sprayed onto the throat to numb it and help prevent gagging during the test. The numbing usually lasts about 30 minutes. You may be given medicine to open up the nasal passages and dry up the secretions in the nose and throat. This lets the doctor see the structures in the throat more clearly.

You will sit in a chair for the procedure. To look at the back of the throat, larynx and vocal cords, the doctor wears a head mirror with a bright light hooked to it and inserts a thin, flexible scope (laryngoscope) into your nose and gently moves it down your throat.

Direct rigid laryngoscopy is done under a general anesthetic (you will be unconscious). It is usually an outpatient procedure in a hospital operating room or endoscopy room. This type of laryngoscopy may be used to remove something from the throat, collect tissue samples for biopsy, remove polyps from the vocal cords or perform laser treatment.

Once the anesthetic is working, the doctor will insert the rigid laryngoscope into your mouth and down your throat to look at the larynx and vocal cords and to remove tissue.

After the laryngoscope is removed, you will be watched for 1 to 2 hours after the test. You won’t be allowed to eat or drink anything until you can swallow without choking.

After the procedure, you may have a sore throat and a hoarse voice for a few days. You may spit up a small amount of blood if a biopsy was taken. Ask your doctor how much bleeding is normal and how long it might last. If your vocal cords were affected by the test, you will be given instructions about resting your voice and when you can get back to normal activities.

Laryngoscopy is a fairly safe procedure. Side effects are rare but may include:

• allergic reaction to the anesthetic
• infection
• bleeding
• vocal cord spasm
• mouth or throat ulcers
• injury to tongue, lips or teeth
• swelling or blockage of the airway

A normal result means your throat, larynx and vocal cords look normal.

An abnormal result can mean you have:

• nodules or scars on the vocal cords
• polyps on the larynx
• a larynx that is red or swollen because of injury or infection
• acid reflux (gastroesophageal reflux disease or GERD)
• vocal cords that can’t move correctly (paralysis of the vocal cords)
• thinning of the muscle and tissue of the larynx
• cancer of the larynx

If cancer is found in the biopsy samples, you will have more tests to help determine how advanced the cancer is.

Preparing children before a test or procedure can lower anxiety, increase cooperation and help them develop coping skills. Preparation includes explaining to children what will happen during the test, including what they will see, feel, hear, taste or smell. Preparing a child for laryngoscopy depends on the age and experience of the child.