Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope
CPT4 code
Name of the Procedure:
Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope (Direct Operative Laryngoscopy)
Summary
Direct Operative Laryngoscopy is a medical procedure in which a doctor looks inside the larynx (voice box) using specialized instruments, such as an operating microscope or telescope, to remove a foreign object. This minimally invasive procedure allows for detailed visualization and precise removal.
Purpose
The procedure addresses issues related to foreign objects lodged in the larynx. The goal is to safely remove the foreign body, which may be causing symptoms such as difficulty breathing, coughing, or voice changes, and to prevent further complications such as infection or damage to the larynx.
Indications
- Sudden onset of breathing difficulties
- Persistent coughing or choking sensation
- Hoarseness or voice changes
- History of accidentally swallowing or inhaling a foreign object
- X-ray or imaging studies indicating a foreign body in the larynx
Preparation
- Patients are generally instructed to fast (no food or drink) for several hours before the procedure.
- Adjustments may need to be made in current medications, particularly blood thinners.
- Pre-procedure diagnostic tests such as chest X-rays or CT scans may be required to locate the foreign body.
Procedure Description
- The patient is given anesthesia, typically general anesthesia, to ensure comfort and immobility.
- An operating microscope or telescope is inserted through the mouth to visualize the larynx directly.
- Specialized instruments are used to carefully extract the foreign body.
- The area is inspected to ensure no additional foreign material is left and to check for any inadvertent injury.
Duration
The procedure typically takes 30 to 60 minutes, depending on the complexity and the location of the foreign body.
Setting
The procedure is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Otolaryngologist (ENT specialist) performing the procedure
- Anesthesiologist managing anesthesia
- Surgical nurses assisting during the operation
Risks and Complications
- Common risks include sore throat, minor bleeding, and hoarseness.
- Rare but possible complications include injury to the larynx or vocal cords, infection, or adverse reactions to anesthesia.
Benefits
- Immediate relief from symptoms caused by the foreign body.
- Prevention of further complications such as infection or airway obstruction.
- Improved breathing and voice function.
Recovery
- Patients are usually monitored in a recovery room until the effects of anesthesia wear off.
- Sore throat and mild discomfort are common and usually resolve within a few days.
- Voice rest and avoiding heavy lifting or strenuous activities may be recommended for a short period.
- Follow-up appointments are scheduled to monitor recovery and ensure no complications arise.
Alternatives
- Observation: In certain cases, if the foreign body is not causing significant symptoms, careful monitoring might be an option.
- Bronchoscopy: Another minimally invasive procedure to visualize and possibly remove foreign bodies from the bronchial tubes.
Pros of Direct Operative Laryngoscopy include precise removal and direct visualization. Cons may include the need for general anesthesia and potential risks of surgery.
Patient Experience
Patients generally do not feel pain during the procedure due to anesthesia. Post-procedure, they may experience a sore throat, hoarseness, and mild discomfort, all of which are manageable with prescribed pain medications and supportive care. Regular follow-ups ensure a smooth recovery.