Laryngoscopy

A laryngoscopy (pronounced “lair-in-GAHS-kuh-pee”) is a procedure healthcare providers use to examine your larynx (voice box). During the procedure, they’ll use a laryngoscope — a tube with a light and camera — to look at your larynx.

You may need this test to see what’s causing speaking and swallowing issues. It may help your healthcare provider diagnose common conditions, like laryngitis, or identify abnormal lesions, like vocal cord nodules and polyps. Providers also use them to diagnose more serious conditions, like throat cancer.

Think of it this way: A laryngoscopy is one of the most important procedures providers use to find out what’s causing symptoms related to your voice box. It gives them direct access to your larynx.

Types

There are different kinds of laryngoscopy, including:

• Flexible laryngoscopy: Usually, healthcare providers use a flexible fiberoptic scope with a tiny camera to view your larynx. They gently insert it through your nose after they’ve numbed the area. It usually takes place at your provider’s office and lasts only a few minutes.
• Direct laryngoscopy: This type happens in an operating room. While you’re under general anesthesia (asleep), your provider inserts the scope inside your mouth. This allows them to see far back into your throat. They may use tools inside the scope to remove tissue for a biopsy.

Your provider may use a mirror (like the kind dentists use) to view your voice box. This is sometimes called an indirect laryngoscopy. But this approach is much less common nowadays.

How does a laryngoscopy work?

During a laryngoscopy, a specialist uses a scope to view your voice box. Healthcare providers that perform them include otolaryngologists (ENTs) and laryngologists. The steps involved, type of scope and where it takes place vary.

Flexible laryngoscopy

Generally, there’s nothing special you need to do to prepare for a flexible laryngoscopy. Here’s what you can expect during the procedure:

1. Your provider may apply a small amount of numbing medicine and a decongestant to your nose or throat. The medicine may taste bitter, and you might want to cough at first. But the urge is likely to go away. The numbing sensation could last about 30 minutes.
2. Then, they’ll insert the scope into a nostril and look down your throat. Or they may use a special scope that’s inserted through your mouth.
3. In some cases, your provider may ask you to speak during the test to see how your voice box is working.

Direct laryngoscopy

You’ll need to prepare for surgical laryngoscopy. This may involve fasting and arranging for someone to drive you home afterward. Your provider will give you instructions so you know what to do.

The procedure happens while you’re under general anesthesia in an operating room. There are different scopes and techniques your provider may use during surgery. Usually, they’ll send the scope through your mouth to access your larynx. If needed, they can send tools through the scope, so they can remove tissue for testing. Or they may remove abnormal tissue (like a polyp) as a part of treatment.

Usually, you’re able to go home the same day.

What are the risks of this test?

Laryngoscopies are generally safe. Complications are rare.

Still, there may be risks or unpleasant side effects (usually temporary) depending on the type of laryngoscopy you receive.

Your healthcare provider will review potential negatives before you agree to the procedure. They can also explain the steps they take to reduce risks and help you manage side effects that may arise.

What should I expect after the test?

Recovery varies depending on the type of laryngoscopy you get. For example, your throat may feel numb after a flexible laryngoscopy (from the numbing medicine). You may have a sore throat or notice some hoarseness after a direct laryngoscopy.

Your healthcare provider will explain what to expect. They’ll also give you instructions on how to care for yourself during your recovery.

When should I know the results of the test?

You’ll know the results from in-office flexible laryngoscopy right away. Biopsy testing done from a surgical direct laryngoscopy can take about one week. It takes more time when the procedure involves lab analysis.

What type of results do you get and what do the results mean?

Normal results mean that everything looks like it should. Abnormal results may mean your healthcare provider found suspicious tissue. It may indicate an issue with how your speaking and swallowing muscles work.

Your provider will review the results with you and let you know if you need treatment or more testing.

What is the difference between a laryngoscopy and an endoscopy?

Both a laryngoscopy and an upper endoscopy (EGD) allow healthcare providers to use a scope to look inside your body. Unlike a laryngoscopy, an EGD helps providers view your digestive tract. For example, a gastroenterologist may do an EGD to diagnose conditions like acid reflux or celiac disease.

How painful is a laryngoscopy?

For an in-office laryngoscopy, you may feel discomfort when the laryngoscope goes in. It may trigger your gag reflex. But the numbing medications your provider gives you work to prevent this. You won’t feel any pain during a surgical laryngoscopy. You’ll be asleep the whole time.