What is laryngoscopy?

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.

How long a laryngoscopy takes is similar for the three types:

• An indirect test takes 5 to 10 minutes.
• A direct flexible test takes about 5 minutes.
• A direct rigid test takes 15 to 30 minutes.

Indirect laryngoscopy and direct flexible laryngoscopy

In general, there's nothing you have to do before this test, unless your doctor tells you to.

Direct rigid laryngoscopy

Rigid laryngoscopy is done with a general anesthetic. Do not eat or drink for 8 hours before the procedure.

Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.

Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your test. Your doctor will tell you if you should stop taking any of them before the test and how soon to do it.

If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your procedure. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.

All types of laryngoscopy have a small chance of causing swelling and blocking the airway. If your airway is partly blocked 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 done, there is a very small chance of bleeding, infection, or a tear in the airway.

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 will taste 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. 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.

If a biopsy was done, it may take several days for your doctor to know the results.

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).