Laryngoscopy

Laryngoscopy is a medical procedure used to examine and treat various conditions that affect the voice box (larynx), vocal cords and other areas of the throat. It is an important tool in diagnosing the cause for chronic coughing, hoarseness, as well as swallowing and breathing problems.

The larynx is at the top of your windpipe (trachea) and helps you talk, breathe and forms a seal for the trachea when you swallow. The larynx also houses the vocal cords, which vibrate to make sounds as you speak. 

This procedure is typically performed awake in a clinic office or hospital by health care professionals specializing in otolaryngology (ear, nose and throat or ENT).

If you or a loved one are scheduled for a laryngoscopy, read on to understand more about the procedure and what to expect before, during and after the test.

Types of laryngoscopy

There are several types of laryngoscopy. The most common include: 

• Flexible laryngoscopy (or fiber-optic laryngoscopy) can also be performed in the office. A thin, flexible scope is put through your nose into your larynx. The camera attached to the scope sends images to a screen so your provider has a clear view of your vocal cords and larynx. Occasionally, it can also be used to remove a piece of tissue (a biopsy) to be tested in a lab. 
• Direct laryngoscopy is often done in a hospital or clinic under general anesthesia (medicine to help you relax and sleep). It uses a wider, harder tube that is inserted directly into your mouth and down your throat. During this procedure, a biopsy or surgery may be done.

What to expect during a flexible laryngoscopy

Typically, there is no preparation for a flexible laryngoscopy. 

• This exam is typically performed in a doctor’s office.
• You sit up straight in a high-backed chair with a headrest.
• A numbing medication or local anesthetic will be sprayed into your nose and throat to numb the areas. This helps prevent gagging as the scope is passed down your throat. 
• Your provider will gently pass the flexible scope into your nostril and look at your throat. The insertion may make you cough at first, but this will stop as the numbing drug begins to work.
• The camera attached to the laryngoscope sends pictures to a screen so your provider can see inside your throat. 
• You may be asked to make sounds or speak to check the movement of your vocal cords.
• The exam may take 30 seconds to 2 minutes.

Possible reactions to a flexible laryngoscopy are usually minimal, but may include gagging and coughing.   

How to prepare for a direct laryngoscopy

For a direct laryngoscopy, you will receive general anesthesia. Here are some steps to ensure everything goes smoothly:

• Sign a consent form: You may be asked to sign a form giving your provider permission to perform the procedure. Read the form carefully and ask your provider if anything is unclear.
• Adjust medications: Your provider may ask you to adjust or temporarily stop your medications and/or dosage, especially blood thinners, to reduce the risk of bleeding during the procedure. If you have ongoing conditions such as diabetes or heart disease, your provider will give you specific instructions about your medications.
• Fasting: You will typically need to stop eating or drinking hours before the procedure. Fasting helps ensure your stomach is empty, reducing the risk of problems like vomiting.
• Imaging: Your provider may want you to take throat X-rays before the procedure.
• Make arrangements: If you are sedated, you will not be able to drive yourself home afterward. Arrange for a responsible adult to bring you home from the hospital or surgical center. You may need to take time off work or arrange help for childcare, household chores and other tasks.

Let your provider know if you have allergies or reactions to medications, latex or tape and if you are pregnant or think you may be pregnant.

What to expect during a direct laryngoscopy

• This exam is done in an operating room.
• You may be asked to change into a gown and remove any jewelry or other objects. 
• You lie on a bed or table with your head propped up.
• You may be given a sedative medicine through an intravenous (IV) line to help you relax and feel sleepy. 
• A numbing medication or local anesthetic will be sprayed into your throat to numb the area. This helps prevent gagging as the scope is passed down your throat.
• During the procedure, trained medical professionals will closely monitor your vital signs, such as heart rate, blood pressure and oxygen levels.
• Once sedated, a laryngoscope will be gently inserted into your throat. 
• The camera attached to the scope sends pictures to a screen so your provider can see inside your lungs. Tools may also be used to take a sample, remove tissue or a foreign object or perform other procedures.
• When the exam is done, the laryngoscope is removed.
• The procedure may take 30 minutes, depending on why your provider is performing the procedure.

Possible side effects of a direct laryngoscopy include:

• Reaction to the medication (sedation or general anesthesia) that makes you relax and sleep
• A sore throat or tongue
• Chipped or broken teeth 

If you have any worries or questions about getting a laryngoscopy, it's important to talk to your provider. They’ll help you understand everything and ensure your safety during the procedure.

Recovery from a laryngoscopy

If your exam is done in your provider’s office without anesthesia or sedation, you can go home after the laryngoscopy.

If you have anesthesia, you’ll be taken to a recovery area where you’ll rest until the medicine's effects wear off. You may feel a little groggy or sleepy for a short time. You will need to have someone bring you home.

Your nose and throat may feel numb after the procedure. This usually wears off in about 20 minutes. You should avoid eating or drinking while your mouth and throat are numb.

You may experience mild side effects after the procedure, such as a sore throat, coughing or a hoarse voice. These symptoms are usually temporary and should improve within a day or two. Warm water gargles and throat lozenges may help.

Your provider will give specific post-procedure instructions on what you can and can’t do after the test. 

How do I understand my results?

After your laryngoscopy, your health care provider will review what they found during the exam. If they took a tissue sample, the results may take some time to get.

Depending on the results, your provider may schedule a follow-up appointment to discuss the findings, treatment plans or further tests as needed. If you have questions about your results, ask your provider to help you understand.

Expert care 

At Banner Health, we provide compassionate, expert care to support your voice and throat health. If you have questions about laryngoscopy or wish to schedule a procedure, contact us today. Your journey to better health begins with Banner Health.