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Laryngoscopy, indirect; with biopsy

CPT4 code

Name of the Procedure:

Laryngoscopy, Indirect; with Biopsy

Summary

A laryngoscopy is a medical procedure used to examine the larynx (voice box). An indirect laryngoscopy specifically uses a mirror or a fiber-optic scope to view the larynx. This procedure can be accompanied by a biopsy, where a small tissue sample is taken for further examination.

Purpose

This procedure is used to diagnose issues related to the larynx, such as hoarseness, difficulty swallowing, persistent cough, or suspicious growths. The goals are to identify the underlying cause of symptoms and, if necessary, to acquire tissue samples for further analysis to detect infections, inflammations, or cancers.

Indications

  • Persistent hoarseness or voice changes
  • Chronic cough
  • Difficulty or pain when swallowing
  • Unexplained throat pain
  • Suspected tumors or growths in the throat area
  • Descriptive symptoms of laryngeal cancer

Preparation

  • Fasting for several hours before the procedure might be required.
  • Avoiding certain medications (such as blood thinners) as per doctor's instructions.
  • A thorough medical history and possibly some pre-procedure tests like blood work.

Procedure Description

  1. The patient is seated in a chair.
  2. A topical anesthetic is sprayed into the throat to numb the area.
  3. A small mirror or a fiber-optic scope is gently inserted into the mouth and positioned in the back of the throat to provide a clear view of the larynx.
  4. The doctor views the larynx and, if necessary, takes a small tissue biopsy using specialized tools.
  5. The tissue sample is sent to a lab for analysis.

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is usually performed in an outpatient clinic or a doctor's office.

Personnel

  • An otolaryngologist (ENT specialist)
  • A nurse or medical assistant

Risks and Complications

  • Mild discomfort or gagging sensation
  • Sore throat post-procedure
  • Bleeding at the biopsy site
  • Risk of infection
  • Rarely, a reaction to the topical anesthetic

Benefits

  • Accurate diagnosis of laryngeal conditions
  • Early detection of potentially serious issues like cancer
  • Minimal invasive procedure with relatively quick recovery

Recovery

  • Throat soreness may persist for a few hours; lozenges and warm liquids can help.
  • Avoiding strenuous activities or heavy lifting for at least 24 hours.
  • Follow-up appointment to discuss biopsy results.
  • Most patients can return to normal activities shortly after the procedure.

Alternatives

  • Direct laryngoscopy which is more invasive and typically requires general anesthesia.
  • Imaging studies like CT or MRI scans which can visualize the area but not obtain tissue samples.
  • Watchful waiting, in cases where symptoms are mild and not worsening.

Patient Experience

Patients may feel a slight gagging sensation and discomfort during the procedure. Post-procedure, throat soreness might be experienced for a few hours. Pain management is usually straightforward with mild anesthetics and over-the-counter remedies.

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