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Laryngoscopy Surgery: The procedure, risks, complications, preparations

  • Posted on- Aug 04, 2016
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Laryngoscopy involves the visual examination of the back of the throat, which includes the larynx (voice box), with a camera. This procedure will not only help in establishing a diagnosis, but also in the treatment of certain conditions involving the larynx. A laryngoscopy procedure involves the larynx and surrounding structures within the windpipe that controls the vocal cords.

What are the reasons behind a laryngoscopy procedure?

A laryngoscopy is performed for the following reasons:

  • To examine condition of the vocal cords
  • Removal of laryngeal polyps, individual nodules, and any additional benign abnormalities
  • Removal of abnormal tissue, which is then sent to a pathologist for examination

How a laryngoscopy procedure is performed?

A laryngoscopy procedure may be performed in the following manner:

Indirect Laryngoscopy

  • This procedure is performed in the physician’s office and usually requires no anaesthesia. Sometimes, a local anaesthetic agent may be sprayed onto the back of the throat, to prevent the patient from gagging
  • The physician uses a head gear fitted with a mirror, to focus light onto the back of the throat
  • During this examination, the patient may be asked to make sounds, which causes the vocal cords to move. Using a piece of gauze to hold down the tongue, the physician examines the state of the vocal cord with a tiny mirror

Direct Flexible Laryngoscopy

  • Medication may be used to reduce secretions in the nose and throat, prior to the procedure. The examination is done after numbing the nostrils and throat, with a local anaesthetic agent
  • An instrument, called the laryngoscope, is then inserted through the nose and passed down the throat, to examine the vocal cords. This instrument is fitted with a camera and the physician views the transmitted images on a monitor

Direct Rigid Laryngoscopy

  • This procedure is performed under general anaesthesia
  • A rigid laryngoscope (an instrument fitted with a camera) is passed into the throat, via the mouth
  • The surgeon can visualise the vocal cords and also use the instrument to collect samples of tissue for examination
  • It may be also used to remove polyps/nodules (types of growths) on the vocal cords, or remove foreign objects lodged in the throat

An otolaryngologist surgeon performs the Laryngoscopy procedure. An Indirect Laryngoscopy lasts about 5-10 minutes. A Direct Laryngoscopy procedure takes 15-30 minutes for its completion.

Preparations needed before a laryngoscopy procedure

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken.
  • Inform the physician if you are allergic to any local anaesthetics, lidocaine, etc.
  • Remove any dentures prior to the procedure
  • Prior to a direct rigid laryngoscopy procedure, inform the physician about any current medications you are taking, including blood thinning medications
  • For procedures under general anaesthesia, avoid drinking or eating for at least 8 hours prior to a Laryngoscopy

Risks and complications during laryngoscopy surgical procedure

There are general factors that increase the risk of getting complications during surgery and they include:
  • Generally greater the degree of obesity, greater is the surgical risk
  • Longer the smoking history (in pack years smoked), greater the surgical risk
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high haemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness, such as autoimmune disorders, chronic infections
  • Poor immune system due to a variety of causes

A few very rare, but possible risks of the Laryngoscopy procedure include:

  • Swelling and airway obstruction
  • Bleeding or infection following the removal of tissue from the vocal cords
  • Anaesthetic complications

Risks and complications after laryngoscopy surgical procedure

The possible risks and complications that may arise after a laryngoscopy procedure are:
  • Excessive bleeding
  • Bleeding or infection following removal of tissue from the vocal cords
  • Swelling of the neck tissues

Post-operative care needed after a laryngoscopy surgical procedure

At home, the following post-operative care is recommended, after a laryngoscopy procedure:
  • Avoid smoking
  • Avoid speaking for some time - individuals are advised to write written messages, in order to communicate
  • Slowly resume daily activities as soon as possible, which aids in faster recovery
  • Keep the head elevated for a period of time
  • Complete the course of prescribed medication, as advised by your physician
  • Avoid taking non-prescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain as per the physician’s advise
  • Avoid all activities that are physically strenuous, if breathing is difficult follow the physician’s advise

Comments

user profile image
31-01-2017 12:12 PM

I had went through laryngoscopy to remove polyps on the vocal cords. Result was quite good.

user profile image
26-08-2016 01:42 PM

The information you shared is very useful. It comprises of all the things ranging from causes, symptoms to cost.

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