Laryngoscopy, direct, operative, with foreign body removal
CPT4 code
Name of the Procedure:
Laryngoscopy, Direct, Operative with Foreign Body Removal
Common Names: Direct Laryngoscopy with Removal of Foreign Body
Summary
Laryngoscopy, direct, operative, with foreign body removal is a medical procedure where a doctor uses a specialized instrument to view the inside of the larynx (voice box) and remove any foreign objects that may be lodged there.
Purpose
The procedure addresses the issue of a foreign body obstructing the larynx, which can cause breathing difficulties, pain, or infection. The primary goal is to safely remove the obstruction to restore normal airway function and prevent further complications.
Indications
- Persistent coughing or choking
- Difficulty breathing or speaking
- Sudden onset of hoarseness
- Throat pain
- Suspected inhalation or swallowing of an object
Preparation
- Patients may be instructed to fast for several hours before the procedure.
- A thorough medical history and physical examination will be conducted.
- Relevant diagnostic tests, such as X-rays or CT scans, may be performed to locate the foreign body.
Procedure Description
- The patient is usually given anesthesia or sedation to minimize discomfort and ensure they remain still.
- A laryngoscope (a thin, flexible or rigid tube with a light and camera) is gently inserted through the mouth and into the throat.
- The doctor examines the larynx and surrounding areas for the foreign body.
- Specialized tools are used to grasp and remove the foreign object.
- The area is checked again to ensure the foreign body has been fully removed and there is no additional damage.
Duration
The procedure typically takes about 30 to 60 minutes, depending on the complexity and location of the foreign body.
Setting
This procedure is usually performed in a hospital operating room or a specialized outpatient surgical center.
Personnel
- ENT (Ear, Nose, and Throat) surgeon or an otolaryngologist
- Anesthesiologist
- Operating room nurses and surgical technologists
Risks and Complications
- Bleeding
- Infection
- Damage to surrounding tissues
- Vocal cord injury
- Swelling of the throat leading to breathing difficulties
- Reactions to anesthesia
Benefits
- Immediate relief of symptoms caused by the foreign body
- Restoration of normal breathing and speaking functions
- Prevention of further complications, such as infections or tissue damage
Recovery
- Patients may experience a sore throat or mild discomfort post-procedure.
- Instructions will include rest, hydration, and over-the-counter pain relievers.
- Avoid straining the voice and follow-up appointments may be necessary to monitor recovery.
- Most patients recover fully within a few days to a week.
Alternatives
- Observation and monitoring if the object is not causing critical symptoms
- Non-invasive methods like coughing, or the Heimlich maneuver in emergency situations
- Endoscopic techniques as an alternative to direct laryngoscopy, depending on the foreign body's location and size.
Patient Experience
Patients may experience anxiety before the procedure, which is mitigated by sedation or anesthesia. Post-procedure, a sore throat and mild discomfort are common and managed with pain relievers. Most patients report significant symptom relief shortly after the foreign body is removed.