Laryngoscopy: What Is It?

Laryngoscopy is an endoscopic medical procedure to look at the larynx (voice box) and vocal cords. It also allows direct viewing of structures in the posterior pharynx and postcricoid regions of the upper airway. Specialized tools can be utilized during laryngoscopy to perform therapeutic interventions in the larynx (such as vocal cord injections or laryngeal adhesiolysis) or to conduct sampling (biopsy or brushing).

Why Is a Laryngoscopy Performed?

A laryngoscopy is most commonly used to diagnose and treat problems related to the larynx, such as vocal cord paralysis, esophageal strictures, varicosities, ulcerations or masses. It can also be used to evaluate dysphonia (hoarseness), the larynx after radiation therapy, or difficulty in clearing secretions from the trachea. A laryngoscopy may also be used to evaluate upper airway obstruction or during laryngeal surgery.

How to Prepare for a Laryngoscopy

Preparing for a laryngoscopy can involve several steps depending on the reason for the laryngoscopy and the patient’s medical history. Before the procedure, it is important to tell your healthcare provider if you have any allergies and to review any medications you’re already taking. Depending on the particular laryngoscopy procedure you’re having, you may need to take other steps to prepare.

  • Your healthcare provider may ask you to have nothing to eat or drink for several hours before the procedure.
  • Your healthcare provider may ask you to stop taking medications or dietary supplements several days before the procedure, as these may interfere with the results.
  • Your healthcare provider may also ask you to stop smoking a few days before and after the procedure, as this may also interfere with the results.

If you are having an imaging procedure, you may be asked to take certain safety measurements before the laryngoscopy, such as removing any jewelry or removeable dental work.

What to Expect During a Laryngoscopy

A laryngoscopy typically does not require any sedation and is usually an outpatient procedure. During the procedure, you may be asked to lie down on your back. Your healthcare provider may ask you to open your mouth wide and/or stick out your tongue in order to make the throat fields more accessible. Your healthcare provider may ask for you to gargle or to take deep breaths during the procedure. During the procedure, you may feel some pressure as the scope and instruments move about in the throat.

Types of Laryngoscopies

There are several different types of laryngoscopies. The type your healthcare provider chooses for you will depend on the investigator's objectives, which may include diagnosis, monitoring or performing therapeutic interventions.

  • Laryngotracheoscopy: This procedure uses a fiberoptic scope to examine both the larynx and the trachea (windpipe). It is an extremely safe and noninvasive procedure.
  • Direct laryngoscopy: This laryngoscopy uses a laryngoscope with a curved blade to help visualize the larynx. It is usually used to inspect or treat lesions within the larynx.
  • Transnasal laryngoscopy: This laryngoscopy involves the use of a flexible laryngoscope that is inserted through the nose into the pharynx and larynx. It can be used to diagnose or monitor conditions such as vocal polyps or benign tumors.

Risks of Laryngoscopy

Although laryngoscopy is generally a safe procedure, there are some risks associated with it. These include:

  • Excessive bleeding
  • Infection
  • Damage to the vocal cords or other structures
  • Airway obstruction
  • Allergic reactions to medications or contrast agents

Most of these risks can be minimized with proper preparation and technique, so it is important to consult with your healthcare provider before undergoing a laryngoscopy procedure.