What Should I Expect During Laryngoscopy?

A laryngoscopy is a procedure in which a doctor uses a laryngoscope, a long and narrow instrument with a light on one end, to examine the larynx and vocal cords. The larynx, also known as the voice box, is an organ that is located between the tongue and trachea, the tube that draws oxygen into the body. The vocal cords are membrane tissue that line the larynx and make noise through vibration. An examination of these organs may need to be performed to determine the cause of any throat pain or difficulty speaking. There are two categories of the procedure: indirect or direct, and a patient’s experience may vary widely depending on which type he or she has performed.

Indirect laryngoscopy is performed by a doctor holding a small mirror near the throat while the patient’s mouth is open to view the throat. The doctor wears headgear with a mirror and light to reflect the view of the throat in order to get the clearest view possible. This version of the procedure is typically short, lasting approximately ten minutes.

Since the laryngoscope is inserted down the throat, it can cause gagging. To prevent this, a doctor may apply a spray anesthetic to relax and numb the throat. In order to view the throat, the doctor may hold onto the tongue, which may be uncomfortable for some patients. Since the throat is obstructed with the inserted scope and the tongue is being held down, verbal communication may be difficult, so the doctor may advise a patient to perform a motion to indicate any pain or other issues.

The more common type of the procedure is a direct laryngoscopy. There are two possible ways it can be performed: either a flexible or rigid procedure. During a direct flexible procedure, the doctor uses a flexible laryngoscope that is placed up into the nose and then out of the throat. A direct rigid procedure uses a firm laryngoscope that is inserted into the mouth and down the throat while the patient is sedated. This version tends to be implemented in cases where a foreign object is obscuring the throat. Both direct flexible and direct rigid examinations take approximately 30 minutes.

A direct flexible laryngoscopy will typically only require the use of a spray anesthetic to numb the inside of the nose and throat to lessen any discomfort of having the laryngoscope inserted. Some patients may experience apprehension at having an object inserted up their noses, but it is generally not painful, particularly if numbing spray is used.

The most serious of the procedure types tends to be the direct rigid version. During this procedure, the patient is completely sedated with general anesthesia and is therefore asleep the entire time. An ice pack may be placed onto the throat to keep the area from swelling from the insertion of the rigid laryngoscope. Patients who have this procedure performed will generally have to be supervised afterward until the doctor knows the patients can safely swallow and are not having any adverse reactions to the anesthesia.