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Direct laryngoscopy - adult


Before you agree to have your laryngoscopy it is important to know all you can about it.  The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.



What is the problem?

You may have a problem in your larynx, which is commonly called your voice box. A laryngoscopy examination under a general anaesthetic is needed to find out what is wrong.


What is the larynx?

Your larynx is deep inside your throat just behind your Adam's apple. It contains your vocal cords, which you use when speaking.

Your larynx starts at the back of your throat, called the oropharynx and extends down to your windpipe, called the trachea.

Direct laryngoscopy - adult
Direct laryngoscopy - adult 2

What has gone wrong?

You may have problems with your voice, swallowing or breathing. We use a laryngoscopy to find the cause for the following conditions:


  • Nerve or structural injury.
  • Voice problems, such as a hoarse voice, weak voice or no voice.
  • Throat and ear pain.
  • Bloodstained saliva or sputum.
  • Difficulty in swallowing.
  • A sensation of a lump in the throat.
  • Throat Injuries.
  • Narrowing of the throat, called a stricture.
  • Obstructions or masses in the airway.



Using the laryngoscope we can also perform some surgical procedures, including:


  • Removing foreign objects.
  • Taking a small tissue sample, called a biopsy.
  • Removing polyps from the vocal cords.
  • Performing laser treatment.
Direct laryngoscopy - adult 3

The aims

In the outpatient department, you will probably have had an indirect laryngoscopy, where your surgeon looks into your throat using a mirror. For a direct laryngoscopy we look directly into your larynx using a special telescope, called a laryngoscope. You will be unconscious with a general anaesthetic while this is done. We will do a detailed examination of all the parts of your larynx, including your vocal cords.


If we find an abnormal swelling we usually do a biopsy and send it to the laboratory for tests. Biopsies are very small; you will not need stitches and the area usually heals quickly.


The benefits

Examining your larynx in this way will help us find out what has gone wrong. Being unconscious with a general anaesthetic will stop you coughing or gagging on the laryngoscope during the procedure.


Are there any alternatives?

X‑rays and scans are not very good for showing the inside of your larynx. The only way to directly view your larynx is to use a special telescope.


There is a procedure that uses a smaller flexible telescope. This can be done under local anaesthetic. This flexible laryngoscopy may be done as an alternative if you are not fit for a general anaesthetic. It may also be done instead of using the rigid scope at the preference of your surgeon. This depends on your symptoms and the possible causes.


What if you do nothing?

You may have a problem with your larynx that would go unrecognised if you do not have this procedure. You could miss out on essential treatment. A problem in your larynx might cause serious problems with your voice, swallowing or breathing.


Author: Mr Robert Ruckley MB. ChB.  F.R.C.S.  Consultant ENT surgeon.

© Dumas Ltd 2006

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