Laryngoscopy
Published by Bupa's health information team, January 2010.
This factsheet is for people who are having a laryngoscopy, or who would like information about it.
Laryngoscopy is a procedure that allows doctors to look at the back of the nose, throat and vocal cords (the larynx).
You will meet the doctor carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.
- About laryngoscopy
- Preparing for a laryngoscopy
- What happens during a laryngoscopy
- What to expect afterwards
- Recovering from a laryngoscopy
- What are the risks?
- Questions and answers
- Related topics
- Further information
- Sources
About laryngoscopy
Laryngoscopy is useful in helping to find out the cause of voice problems, difficulty in swallowing, throat and ear pain, and to check injuries to the throat, narrowing of the throat (strictures), or blockages in the airway.
Laryngoscopy is done in two ways.
- Flexible laryngoscopy (also called nasoendoscopy) uses a thin fibre-optic endoscope, called a laryngoscope. This scope has a tiny light and lens in the tip, and a thin flexible body. It is passed through the nose to the back of the mouth. It is used for check-ups and to make a diagnosis, but usually doesn't allow any further procedure.
- Rigid laryngoscopy uses specially designed metal tubes which pass through the mouth. Special instruments are passed through the tubes to remove a blockage in the throat, take a tissue sample (biopsy), remove polyps from the vocal cords, or perform laser treatment.
Both flexible and rigid laryngoscopy are usually performed by an ear, nose and throat (ENT) specialist.
Preparing for a laryngoscopy
Flexible laryngoscopy is done as an out-patient procedure under local anaesthesia. The local anaesthetic is usually a nasal spray which will decongest the nose, and also make the inside of the nose and the throat numb. This spray doesn't taste very nice, but makes the laryngoscopy much more comfortable, which in turn allows your doctor a much better view of the voice box.
Rigid laryngoscopy is done as a day-case procedure under general anaesthesia, which means you will be asleep during the procedure.
Your hospital will write to you with instructions to follow beforehand. If you are having a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. You may be allowed occasional sips of water for up to an hour and a half before the procedure.
At the hospital, your nurse may check your heart rate and blood pressure.
Your doctor will discuss with you what will happen before, during and after your procedure, and any pain you might have. You can ask questions about the risks and benefits, and if there are any alternatives to the procedure. This will enable you to give your informed consent for the procedure to go ahead, which you may be asked to do by signing a consent form.
Tell your doctor if you're allergic to any medication and if you have asthma, other lung disease, heart problems or arthritis affecting your neck. Also tell your doctor if you have any dental crowns, bridges or loose teeth. The laryngoscope may damage these, although special care will be taken to prevent this. If you have had a lot of dental work done to the top teeth at the front it is very helpful to ask your dentist to make a thin, rigid gum shield to protect these teeth.
What happens during a laryngoscopy
The procedure may take 10 to 30 minutes, depending on what needs to be done.
You will be asked to remove dentures or dental plates, contact lenses, glasses and jewellery.
If you are having general anaesthetic, it will be injected into a vein in the back of your hand. If you are having a local anaesthetic, it is usually given as a nasal spray.
Once the anaesthetic has taken effect, your doctor will carefully pass the laryngoscope down your throat.
A camera lens at the end of the laryngoscope may be used to send pictures from the inside of your throat to a monitor. Alternatively, your doctor may look directly into the laryngoscope to examine your throat and larynx.
If necessary, your doctor will take a biopsy. This is done using special instruments passed inside the laryngoscope and is quick and painless, although you may feel a slight pinch. The biopsy is sent to a laboratory for testing to determine the type of cells and whether these are benign (not cancerous) or cancerous.
If necessary, your doctor will perform surgery to treat your medical condition.
What to expect afterwards
If you have general anaesthesia, you will need to rest until the effects of the anaesthetic have passed. You will usually be able to go home when you feel ready. You will need to arrange for someone to drive you home. After general anaesthesia, you should try to have a friend or relative stay with you for the first 24 hours.
If you have local anaesthesia, it may take several hours before the feeling comes back into your throat. You shouldn't drink hot drinks until the local anaesthetic has worn off.
Results
If you have a biopsy, your results will be ready several days later and will usually be sent to the doctor who recommended the laryngoscopy. At the hospital, your doctor may discuss other findings from the laryngoscopy with you before you leave, or you may be given a date for a follow-up appointment.
Recovering from a laryngoscopy
You're likely to have a sore throat for the first few hours. 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 you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you're in any doubt about driving, always follow your doctor's advice and contact your motor insurer so that you're aware of their recommendations.
Most people have no problems after a laryngoscopy, but you should contact your doctor if you:
- cough up or vomit blood
- have difficulty in breathing
- develop a high temperature
What are the risks?
Laryngoscopy is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
Side-effects
These are the unwanted but mostly temporary effects of a successful procedure, for example, feeling sick as a result of the general anaesthetic.
Side-effects of a laryngoscopy include:
- numbness in the mouth and tongue
- mild sore throat
- loss of voice
- small amount of blood in your sputum
Complications
This is when problems occur during or after the procedure. Most people are not affected.
Your doctor will be experienced at performing laryngoscopies, but even so, a few aren't successfully completed and may need to be repeated.
Complications of a laryngoscopy are uncommon but can include:
- difficulty in breathing - this can be a result of the putting the laryngoscope in the throat or due to effects of the sedative or general anaesthesia
- reaction to the sedative or general anaesthesia - for example, a skin rash or heart problems
- damage to the airway or throat lining - particularly if a biopsy is taken
- damage to teeth - particularly as the laryngoscope is passed through the mouth
The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your doctor to explain how these risks apply to you.
Related topics
Further information
ENT UK
www.entuk.org
Sources
- Riley S, Alderson D. Complications of upper gastrointestinal endoscopy. Guidelines on complications of gastrointestinal endoscopy, 2006. British Society of Gastroenterology. www.bsg.org.uk
- Personal communication, Dr Richard Adamson, Consultant Otolaryngologist, Head and Neck Surgeon, University Department of ENT Surgery, Lauriston Buildings, Edinburgh, 2 December 2009
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: January 2010
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