Test Overview

Laryngoscopy is an examination that lets your
doctor look at the back of your throat, your
voice box (larynx), and vocal cords with a scope (laryngoscope). There are two
types of laryngoscopy, and each uses different equipment.

Indirect laryngoscopy

Indirect laryngoscopy is
done in a doctor’s office using a small hand mirror held at the back of the
throat. Your doctor shines a light in your mouth and wears a mirror on his or
her head to reflect light to the back of your throat. Some doctors now use
headgear with a bright light.

Indirect laryngoscopy is not done as
much now because flexible laryngoscopes let your doctor see better and are more
comfortable for you.

Direct fiber-optic (flexible or rigid) laryngoscopy

Direct laryngoscopy lets your doctor see deeper into your throat. The scope is either flexible or rigid. Flexible scopes show
the throat better and are more comfortable for you. Rigid scopes are often used
in surgery.

Why It Is Done

An indirect or direct laryngoscopy
helps a doctor:

  • Find the cause of voice problems, such as a
    breathy voice, hoarse voice, weak voice, or no voice.
  • Find the
    cause of throat and ear pain.
  • Find the cause for trouble
    swallowing, a feeling of a lump in the throat, or mucus with blood in
    it.
  • Check injuries to the throat, narrowing of the throat
    (strictures), or blockages in the airway.

Direct rigid laryngoscopy may be used as a surgical
procedure to remove foreign objects in the throat, collect tissue samples
(biopsy), remove
polyps from the vocal cords, or perform laser
treatment. Direct rigid laryngoscopy may also be used to help find cancer of
the voice box (larynx).

How To Prepare

Indirect laryngoscopy and direct flexible laryngoscopy

If you wear dentures, you will
remove them just before the examination.

Direct rigid laryngoscopy

Before a rigid
laryngoscopy, tell your doctor if you:

  • Are allergic to any medicines, including
    anesthetics.
  • Are taking any medicines.
  • Take a blood thinner, or if you have had bleeding problems.
  • Have heart problems.
  • Are or might be
    pregnant.
  • Have had surgery or radiation treatments to your mouth or
    throat.

Rigid laryngoscopy is done with a
general anesthetic. Do not eat or drink for 8 hours
before the procedure. If you have this test in your doctor’s office or at a
surgery center, arrange to have someone drive you home after the
procedure.

You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.

Talk to
your doctor about any concerns you have regarding the need for the
test, its risks, how it will be done, or what the results will mean. To help
you understand the importance of this test, fill out the
medical test information form (What is a PDF document?).

How It Is Done

Indirect laryngoscopy and direct flexible
laryngoscopy examinations are generally done in a doctor’s office. Most
fiber-optic laryngoscopies are done by an
ear, nose, and throat specialist (ENT). You may be awake for the
examination.

Indirect laryngoscopy

You will sit straight up in
a chair and stick out your tongue as far as you can. The doctor will hold your
tongue down with some gauze. This lets the doctor see your throat more clearly.
If you gag easily, the doctor may spray a numbing medicine (local anesthetic) into your throat to help with the
gaggy feeling.

The doctor will hold a small mirror at the back of
your throat and shine a light into your mouth. He or she will wear a head
mirror to reflect the light to the back of your throat. Or your doctor may wear
headgear with a bright light hooked to it. He or she may ask you to make a
high-pitched “e-e-e-e” sound or a low-pitched “a-a-a-a” sound. Making these
noises helps the doctor see your vocal cords.

The examination
takes 5 to 10 minutes.

If a local (topical) anesthetic is used
during the examination, the numbing effect of the anesthetic will last about 30 minutes. You can eat or drink
when your throat is no longer numb.

Direct flexible laryngoscopy

The doctor will use a
thin, flexible scope to look at your throat. You may get a medicine to dry up
the secretions in your nose and throat. This lets your doctor see more clearly.
A topical anesthetic may be sprayed on your throat to numb it.

The
scope is put in your nose and then gently moved down into your throat. As the
scope is passed down your throat, your doctor may spray more medicine to keep
your throat numb during the examination. The doctor may also swab or spray a
medicine inside your nose that opens your nasal passages to give a better view
of your airway.

Direct rigid laryngoscopy

Before you have a rigid
laryngoscopy, remove all your jewelry, dentures, and eyeglasses. You will empty
your bladder before the examination. You will be given a cloth or paper gown to
wear.

Direct rigid laryngoscopy is done in a surgery room. You
will go to sleep (general anesthetic) and not feel the scope in your
throat.

You will lie on your back during this procedure. After you
are asleep, the rigid laryngoscope is put in your mouth and down your throat.
Your doctor will be able to see your voice box (larynx) and vocal cords.

The rigid laryngoscope may also be used to remove foreign objects in the
throat, collect tissue samples (biopsy), remove polyps from the vocal cords, or
perform laser treatment.

The examination takes 15 to 30 minutes.
You may get an ice pack to use on your throat to prevent swelling. After the
procedure, you will be watched by a nurse for a few hours until you are fully
awake and able to swallow.

  • Do not eat or drink anything for about 2
    hours after a laryngoscopy or until you are able to swallow without choking.
    You can then start with sips of water. When you feel ready, you can eat a
    normal diet.
  • Do not clear your throat or cough hard for several
    hours after the laryngoscopy.
  • If your vocal cords were affected during the laryngoscopy, rest
    your voice completely for 3 days.
  • If you speak, do so in your
    normal tone of voice and do not talk for very long. Whispering or shouting can
    strain your vocal cords as they are trying to heal.
  • You may sound
    hoarse for about 3 weeks after the laryngoscopy if tissue was
    removed.
  • If nodules or other lesions were removed from your vocal
    cords, you may have to follow total voice rest (no talking, whispering, or
    making any other voice sounds) for up to 2 weeks.

How It Feels

Indirect laryngoscopy

You may feel like gagging
when the mirror is placed in your throat. It may be uncomfortable when the
doctor pulls on your tongue. If this becomes painful, signal your doctor by
pointing to your tongue, since you will not be able to speak. If a spray
anesthetic is used, it tastes bitter, it can make you feel like your throat is
swollen, and it may make you feel that it is hard to swallow.

Direct flexible laryngoscopy

It may feel strange
to have the doctor put the scope up your nose. But it should not hurt and you
will still be able to breathe. If a spray anesthetic is used, it may taste
bitter. The anesthetic can also make you feel like your throat is swollen. You can swallow normally but you may not feel it.

Direct rigid laryngoscopy

You will be asleep and
feel nothing during the laryngoscopy. After the procedure, you may have some
nausea, general muscle aches, and may feel tired for 1 to 2 days. You also may
have a sore throat and sound hoarse. Suck on throat lozenges or gargle with
warm salt water to help your sore throat.

If your child is having this procedure, the same is also true. If your child has a sore throat and is age 4 or older, you can give him or her throat lozenges. Also, a child age 8 or older can gargle with warm salt water.

If a biopsy was taken,
it is normal to spit up a small amount of blood after the laryngoscopy. Talk to
your doctor about how much bleeding to expect and how long the bleeding may
last. Call your doctor immediately if:

  • You have a lot of bleeding or if the bleeding
    lasts for 24 hours.
  • You have any trouble breathing.

Risks

All types of laryngoscopy have a small chance of
causing swelling and blocking the airway. If you have a partially blocked
airway because of tumors, polyps, or severe inflammation of the tissues at the
back of the throat (epiglottitis), you may have a higher
chance of problems.

If complete blockage of the airway occurs,
which is rare, your doctor may need to put a tube in your throat to help you
breathe. Or, very rarely, your doctor may have to make a cut (incision) in your
neck (a tracheotomy).

If a biopsy was taken, there is a very small
chance of bleeding, infection, or a tear in the airway.

Results

Laryngoscopy is an examination that lets
your doctor look at the back of your throat, your
voice box (larynx), and vocal cords with a scope (laryngoscope). If a biopsy was
done, it may take several days for your doctor to know the results.

Laryngoscopy
Normal:

The throat (larynx) does not have swelling,
an injury, narrowing (strictures), or foreign bodies. Your vocal cords do not
have scar tissue, growths (tumors), or signs of not moving correctly
(paralysis).

Abnormal:

Your larynx has inflammation, injury,
strictures, tumors, or foreign bodies. Your vocal cords have scar tissue or
signs of paralysis.

What Affects the Test

If you gag easily, your doctor
may need to do a direct rigid laryngoscopy.

What To Think About

  • Direct rigid laryngoscopy is generally
    recommended for:

    • Children.
    • People who gag easily
      because of abnormalities in their throat structure.
    • People who may
      have symptoms of laryngeal or pharyngeal disease.
    • People who have
      not responded to treatment for laryngeal symptoms.

References

Other Works Consulted

  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
  • Weinberger PM, Terris DJ (2010). Otolaryngology-Head and neck surgery. In GM Doherty, ed., Current Diagnosis and Treatment: Surgery, 13th ed., pp. 224-258. New York: McGraw-Hill.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer Donald R. Mintz, MD – Otolaryngology

Current as ofMay 4, 2017