Laryngoscopy

Laryngoscopy is used for deep diagnosis and treatment of the throat. It is carried out by an experienced otolaryngologist to help patients with problems in the vocal cords, trachea, and nasopharynx. During the examination, the doctor uses special instruments that are inserted into the throat. Due to the intimidating appearance of this procedure, patients are often afraid of it and put it off. Let’s take a closer look at how this happens in order to get rid of unnecessary fears.

Description and types of procedure

When the doctor says that a laryngoscopy is needed, he explains to the patient how it will be done. At the same time, for the successful completion of this manipulation, it is necessary for the patient to be relaxed and calm. But the doctor sets the main task of getting rid of the disease, so he sees nothing wrong in this process. In contrast to the patient, who does not find such a prospect pleasant. A good ENT will quickly calm his ward and explain that they need to be afraid of the consequences of a protracted illness, and not a minute examination. But not every good otolaryngologist can meet a good psychologist. So let’s figure it out ourselves.

How exactly the procedure will be carried out depends on the goals of the doctor. Laryngoscopy may be indicated for examination or treatment. Diagnosis is quick and does not require special preparations. Treatment requires more time and manipulations, but this does not mean at all that therapeutic laryngoscopy will be painful and scary. To solve complex medical problems, anesthesia or anesthesia is always used, in this case too.

If the doctor needs to examine the oral cavity or oropharynx in detail, he will use a special long-handled mirror. This mirror is inserted into the throat and reflects the condition of the mucosa. In medicine, this method of diagnosis is called indirect laryngoscopy, it is suitable for a shallow examination, but the doctor’s actions are very limited. It is used for professional examinations and scheduled appointments for children and adults. This technique has been known for a very long time and the scheme of its implementation has not changed for almost two centuries. In the circles of modern doctors, it is considered a rarity, but in state medical institutions it is mainly used.

For solving more serious problems, this method is not suitable. For example, it is very difficult to perform on young children or to remove growths in the throat. In such cases, direct laryngoscopy is indicated. It is carried out using a flexible or rigid fibrolaryngoscope. This device looks like a thin flexible hose or rigid tube on a handle with an optical system and lighting. Such an instrument is inserted deep into the larynx or trachea for examination. The direct method also allows you to take biomaterial for biopsy, remove polyps, remove foreign bodies. In the case of using a flexible fibrolaryngoscope, local anesthesia is administered, rigid is always performed under general anesthesia in the operating room.

In some cases, it is necessary to examine the nasopharynx, it is impossible to do this through the oral cavity, so the instrument is inserted through the nose. This procedure is called retrograde laryngoscopy. At the same time, local anesthesia is also shown, so the patient does not feel severe discomfort. The device transmits the image to the screen with multiple magnification, so the doctor can examine in detail all the necessary areas. The technique of direct laryngoscopy is considered the most informative and less traumatic. Therefore, you should not be afraid of her.

When is laryngoscopy indicated?

An indirect technique is prescribed for the purpose of a preventive examination or specific complaints. At the same time, the ENT by symptoms can immediately determine which type of diagnosis is needed. As a rule, in polyclinics, for simple tasks, a laryngeal mirror is used, that is, indirect laryngoscopy. In modern clinics, a fibrolaryngoscope or endoscope is used, that is, a direct technique.

This procedure is prescribed for:

• bleeding during coughing;
• pain when swallowing;
• plaques in the ears;
• breathing problems through the nose or mouth;
• sensations of a foreign body in the throat;
• respiratory tract injuries;
• loss or change of voice with unexplained reasons.

The direct method allows you to take materials for analysis and research, remove foreign objects, tumors, papillomas and polyps. Laryngoscopy is considered the main method for calculating throat cancer at all stages. Another attending physician can refer you to such a procedure, for example, after a CT or MRI of the head and neck. Also, any patient can undergo a preventive examination to ensure their health.

Contraindications to the study

Such diagnosis and treatment may not be indicated for all patients. Indirect laryngoscopy is extremely rarely used in young children, since it is very difficult to control the process in this case. However, the direct method also has its contraindications. It is not prescribed against the background of such problems:

• damage to the cervical vertebrae;
• cardiovascular diseases (hypertension, aortic aneurysm, heart disease);
• severe bleeding from the throat;
• during pregnancy;
• stenotic breathing;
• acute inflammation of the mucous membrane, throat;
• epilepsy.

Since direct laryngoscopy is performed with anesthesia or anesthesia, it is very important to find out if the patient is allergic to medications before the session. Also, hypersensitivity is considered a relative contraindication, which greatly complicates the examination. In this case, other types of diagnostics, such as computed tomography, may be prescribed.

Where can I get this procedure and how much does it cost?

As prescribed by the doctor or just for the purpose of a preventive examination, you should first find out where you can do a laryngoscopy. Indirect is carried out in all public medical institutions. To do this, you just need to find an ENT office. Direct most often can be found in private clinics. If serious intervention is required, for example, removal of a tumor, it is better not to save. Expensive equipment in private institutions allows you to conduct a session not only quickly and comfortably, but with its help you get more accurate information that can be “overlooked” when viewed with mirrors. Finding such a clinic in your city is very simple, the Internet will help with this. When searching for a site, you can immediately make an appointment if a phone number or an online appointment form is indicated. Today, in order to get better acquainted with the process, you can search the Internet for photos and videos, although often they only repel patients, despite the fact that in fact they do not cause any harm.

To choose the best clinic and reassure yourself, you can read patient reviews on the sites. Also, responses are often left on city forums, here you can read how laryngoscopy is done, whether it hurts or not, they advise a good doctor. The price of laryngoscopy is individual in each case. An indirect one can be done for free or at a minimal cost in public clinics, an indirect rigid or flexible one will cost a little more. On average, such a service in a private clinic will cost 20-40 dollars, if you just need an examination. The price of treatment can be set only in the clinic itself after the diagnosis.

Preparing for the procedure

If you prepare properly, the reception will be faster and easier. As a rule, conventional indirect laryngoscopy does not require special preparations, it is only recommended to abstain from food 4 hours before the session and drink less. This is necessary in order to reduce the level of the gag reflex. If a direct method is planned, more painstaking preparation is needed. The patient may be assigned additional examinations such as computed tomography or barium examination of the larynx and esophagus.

In addition, in order to reduce risks, the patient should take a blood test a week before the planned procedure. Be sure to check the level of coagulation, conduct allergy tests for medications. The doctor also warns the subject about the ban on certain types of drugs, such as Aspirin and multivitamins, which reduce clotting. If direct rigid laryngoscopy is indicated, then general anesthesia will be required. 7-8 hours before the start of the session, it is forbidden to drink and eat. On the day of the procedure, the doctor needs to be told if any medications were taken, as the components in them can unpredictably affect anesthesia.

How would this happen

Depending on the doctor’s goals, a direct or mirror laryngoscopy will be prescribed. As a rule, the patient knows about the direct in advance so that there is time to prepare. A mirror image is carried out immediately upon arrival at the ENT office for a quick examination. They go through different ways.

Indirect method

First, the doctor will listen to complaints, if any, study the medical history. If the visitor has dentures, they are removed before the examination. Then the ENT and the patient sit on chairs opposite each other. At the same time, there will be another health worker in the office to help. The doctor has a reflector fixed on his head – a round reflector. A mirror is being prepared, it is slightly heated so that it does not fog up during inspection. It will not be hot, it is brought to body temperature.

After preparing the instruments, the patient opens his mouth wide and extends his tongue as far as possible. The ENT grabs the tongue on gauze or a sterile napkin, it will need to be held for a better view. Sometimes the doctor may ask the subject to hold his tongue so that the doctor has both hands free. Then the specialist adjusts the light correctly so that the oropharynx of the subject is illuminated. Slowly, without touching the root of the tongue, the doctor inserts a mirror into the throat. The mirror is at an angle of 120 degrees, which makes it possible to examine the oral cavity, oropharynx, vocal cords. To facilitate the study, the doctor asks to pronounce vowels: and, uh, long a.

If the received information is not enough, after a short break the process is repeated. For one insertion of the mirror, no more than 10 seconds pass. As a rule, one or two examinations are sufficient. Based on the data seen, the ENT makes a conclusion about the health of his ward or prescribes treatment. Sometimes a specialist comes to the conclusion that a mirror examination is not enough. In this case, the direct method is assigned.

Direct Method

This is a slightly more complicated process, but it gives the doctor more information and manipulation. It can be assigned to a small child, for example, to remove stuck objects. Such a session is carried out under local anesthesia, for this a special spray is sprayed into the throat, which quickly anesthetizes. Most often, the patient lies on the couch and throws his head back. A flexible laryngoscope with a light source and optics is inserted into the throat. Sometimes the introduction of a fibrolaryngoscope through the nose is required, in this case, an anesthetic in the form of drops is also used.

The doctor examines and makes a conclusion. The process takes no more than 7-8 minutes.

Direct rigid laryngoscopy takes place exclusively in the operating room. It is needed for surgical manipulations, removal of neoplasms, sampling of biomaterial, etc. The patient does not feel anything, as he is under anesthesia.

Rehabilitation and complications

Before laryngoscopy, you can find out in advance how it is tolerated. After a mirror check, no special rehabilitation is needed. Sometimes, with pressure on the back of the throat, small bouts of nausea occur, which quickly pass. Rigid or flexible diagnosis may be accompanied by complications, although this is rare. When using a flexible hose, attacks of gag reflexes can also occur, but in most cases they are dulled by the action of anesthetics. After the procedure, local anesthesia creates a feeling of a swollen throat, swallowing is a little difficult. These symptoms go away after the drugs wear off.

Rigid laryngoscopy is a bit more complicated. Nothing is felt during the intervention itself, but side effects may occur afterwards. For example, in rare cases, patients’ reviews note a sore throat, a hoarse voice, and difficulty swallowing. Such effects should disappear in 1-2 days. If a biomaterial was taken, blood is periodically released within a day after that. It’s not scary if it lasts no more than a day. Bleeding from the throat and a constant taste of iron in the mouth for 2-3 days is a reason to urgently contact the ENT.

After an examination or treatment, especially a rigid method, patients are advised to stop drinking and eating until the effect of anesthetics wears off. Smokers should definitely refrain from nicotine for another 8-12 hours. If there are complications, such as bleeding, you can only smoke with the permission of a doctor. After the restoration of all functions, it is advised to drink in small sips of warm water, and only then eat.

FAQ

How does laryngoscopy work: does it hurt or not?

Pain relief completely resolves the issue of pain during this process. In extreme cases, it can be just unpleasant from vomiting, but even they are blocked under the influence of local anesthesia. After a biopsy and a rigid intervention, there may be sore throats, which disappear after a couple of days.

How long does this procedure take

A routine examination using mirrors or a flexible laryngoscope will take no more than 10 minutes. In this case, the entire examination takes place in several stages of 5-10 seconds. The operation takes 15 to 60 minutes.

Do I need an additional examination after laryngoscopy?

It is necessary if it is prescribed by a doctor. It is also necessary to visit the ENT if there are long-term side effects: bleeding, severe pain, a shrunken voice. The cause for concern is the symptomatology, which does not go away for 3-4 days.

What can replace it

If you just need a diagnosis, you can use the endoscopic examination. It goes almost the same and its cost is slightly different. Computed tomography is considered a more comfortable examination option for the patient, but do not forget that in this case the subject receives a dose of radiation. In addition, laryngoscopy and endoscopy remain the most informative for diagnosing the organs of the ear, throat and nose.