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Laryngoscopy, indirect; with removal of lesion

CPT4 code

Name of the Procedure:

Laryngoscopy, indirect; with removal of lesion

Summary

Laryngoscopy, indirect with removal of lesion, is a medical procedure used to examine the larynx or voice box and remove abnormal growths or lesions. The doctor uses a mirror and light to view the larynx and special instruments to remove any detected lesions.

Purpose

The procedure addresses medical conditions involving abnormal growths or lesions in the larynx. The goals are to remove these lesions to prevent potential complications, diagnose underlying conditions, and improve symptoms like voice changes or difficulty breathing.

Indications

  • Persistent hoarseness or voice changes
  • Difficulty swallowing or breathing
  • Suspicion of cancerous or benign lesions in the larynx
  • Chronic throat pain
  • Visible lesions noted during routine examination

Preparation

  • Fasting for at least 6-8 hours prior to the procedure
  • Adjustments in medications as advised by the doctor, especially blood thinners
  • Pre-procedure diagnostic tests such as imaging studies or a biopsy may be required

Procedure Description

  1. The patient is seated upright in a specialized chair.
  2. Local anesthesia is sprayed to numb the throat.
  3. A mirror is placed at the back of the throat and a light source is used to illuminate the larynx.
  4. The doctor uses special instruments viewed through the mirror to identify and remove the lesion.
  5. Removed tissue is often sent for lab analysis to rule out cancer.

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is usually performed in an outpatient clinic or a hospital outpatient department.

Personnel

  • Otolaryngologist (ENT specialist)
  • Nurse or medical assistant
  • Anesthesiologist (if general anesthesia is used, though rare for this procedure)

Risks and Complications

  • Sore throat
  • Minor bleeding
  • Infection
  • Hoarseness or changes in voice
  • Rarely, damage to surrounding tissues

Benefits

  • Removal of abnormal lesions which can improve symptoms instantly
  • Facilitates accurate diagnosis through lesion biopsy
  • Minimally invasive with quick recovery

Recovery

  • Rest the voice for a few days following the procedure
  • Avoid strenuous activities and follow a soft or liquid diet if advised
  • Use prescribed pain relievers or throat lozenges as needed
  • Follow up with the doctor to review biopsy results and further treatment if necessary

Alternatives

  • Direct laryngoscopy using a laryngoscope
  • Observation and monitoring if the lesion is benign and not causing significant symptoms
  • Non-surgical options like voice therapy or medications (depending on the condition)

Patient Experience

Patients might feel some discomfort and a sore throat during and after the procedure. Pain is typically mild and manageable with over-the-counter pain relievers. Sedatives and local anesthetics help minimize discomfort, and patients can usually resume normal activities within a short period.

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