Laryngoscopy - Uses, Types, Procedure and laryngoscopy complications

08/11/2022

Laryngoscopy is a procedure used by the doctor to visualize the back of the throat or the larynx and the adjacent areas. Laryngoscopy is often the procedure of choice of the doctors during an obstruction of the larynx, diagnosis of a polyp, cancer, surgery, or tissue biopsy. The equipment used for laryngoscopy is laryngoscope. In this article, we'll discuss laryngoscopy, uses of laryngoscopy, types of laryngoscopy, procedure and complication of laryngoscopy.

What is laryngoscopy?

Laryngoscopy is a widely used procedure by doctors using a laryngoscope, which is an endoscope of the larynx, to visualize the back of the throat i.e. larynx or the voice box. The larynx is a small cartilaginous structure that connects the throat to the windpipe. Laryngoscopy is used to visualize and diagnose problems in this area. 

Uses of laryngoscopy :

Laryngoscopy is used during various situations. The need for laryngoscopy arises during the following situations-

  • When a foreign body is stuck in your throat.
  • Laryngoscopy can be done if you have a recurrent infection whose cause is unknown.
  • When you have a feeling of something stuck in your throat.
  • You have trouble breathing or swallowing.
  • When you have abnormal stridor.
  • When you have unexpected voice changes.
  • Laryngoscopy can be done if you have an earache that won't go away.
  • When you feel a mass in your throat.
  • When the doctors need to confirm the type of growth, whether the growth is benign or cancerous.
  • When the doctors have to remove the growth.

Different Types of Laryngoscopy :

There are various types of laryngoscopy done according to the types of laryngoscopes used. Each laryngoscopy procedure has its benefits and indications. Let's see the various types of laryngoscopy procedures

Indirect laryngoscopy :

Indirect laryngoscopy is the simplest type of laryngoscopy. It uses a small mirror that is held at the back of the throat, and the view obtained of the larynx is a mirror image. It takes very less time and does not require the healthcare provider to anesthetize the patient. 

Direct laryngoscopy :

Direct laryngoscopy is the use of a laryngoscope by the health care provider to directly visualize the larynx. It is frequently used during endotracheal intubation. The laryngoscope may be flexible or rigid. This type of laryngoscopy procedure is done under general anesthesia, so the patient is in deep sleep as well as pain-free.

Flexible fiber optic laryngoscopy :

It uses a small flexible telescope. As the scope is flexible, it gives a wide visualization of the larynx. The tip of the laryngoscope scope is sprayed with numbing medicine.

Direct rigid laryngoscopy :

Direct rigid laryngoscopy has a rigid telescope with a light attached. This type of laryngoscopy is used mostly during surgery or tissue biopsy, where one hand of the doctor will be used for surgery while the other hand can be used to stabilize the laryngoscope.

Video laryngoscopy :

Video laryngoscope uses a laryngoscope with a camera attached to visualize the vocal folds and the remaining part of the larynx. It is an indirect form of laryngoscopy, in which the clinician does not directly visualize the larynx. The larynx is visualized through a camera which is passed down the larynx. It is very useful during endotracheal intubation of difficult cases like patients in critical care, unconscious patients, and severely bleeding patients.

Procedure of laryngoscopy :

The laryngoscopy procedure can be done either without the use of anesthesia or with the use of anesthesia.

Indirect laryngoscopy is the simplest laryngoscopy procedure done without the use of anesthesia. An indirect laryngoscopy mirror pushes down the tongue, and the mirror image of the throat is seen in the mirror.

Typically, laryngoscopy can be completed as an outpatient operation, meaning that you won't need to spend the night in the hospital.

You may have to lie on your back on a bed or table for a test, or you may be able to sit up, depending on the type. A numbing medication will initially be sprayed into your mouth (or your nose) and throat. Less frequently, the test may be performed while you are unconscious (under general anesthesia). In the procedures which require more amount of time, like laryngeal surgery, the patient is given general anesthesia. If the patient is uncooperative, such as a small child, it is best to anesthetize the patient to do the procedure smoothly without harming the child's throat and adjacent structures. 

When the scope is first inserted, you might cough if you're awake. When the numbing medicine starts to take effect, this will end.

Depending on what needs to be done, a flexible laryngoscopy can be completed in as little as 10 minutes, while other laryngoscopies may take longer. Those procedures which need longer time are usually done after giving general anesthesia in an aseptic environment.

Complications of laryngoscopy :

We have very important structures in and around the larynx. Even though the procedure is done by skilled personnel, there are some risks and complications to look out for during laryngoscopy. A few of the complications of laryngoscopy are

● Allergic reaction to anesthesia
● Blunt or penetrating trauma to the oropharynx or the vocal cords, trachea.
● Arytenoid cartilage (one of the cartilage forming larynx)  dislocation.
● Gagging or vomiting.
● Infection due to un-sterilized instruments.
● Hoarseness
● Pain or swelling of mouth, tongue or oropharynx.

These are the complications one should look out for after the laryngoscopy procedure. The procedures which are done in the outpatient department are minor, and the patient can go home after a few hours once the procedure is finished.

Conclusion

Laryngoscopy is a procedure used by the doctor to visualize the back of the throat or the larynx and the adjacent areas. There are various types of laryngoscopes used according to the need to do the laryngoscopy procedure. There are a few complications like hoarseness of voice, infections, and trauma to the larynx and adjacent structures to look out for during the procedure.

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