Name of the Procedure:

Laryngoscopy Direct, With or Without Tracheoscopy; Diagnostic, Except Newborn
Common names: Direct Laryngoscopy, Direct Tracheoscopy

Summary

In a direct laryngoscopy, a healthcare provider uses a special instrument called a laryngoscope to have a close view of the throat, voice box, and vocal cords. Sometimes, the procedure includes examining the trachea. This is mainly diagnostic, meaning it's done to find out what might be causing symptoms such as voice changes, throat pain, or breathing issues. This procedure is not performed on newborns.

Purpose

The procedure addresses diagnostic needs for various throat and airway conditions, such as persistent cough, hoarseness, or obstruction. The goal is to visualize the anatomy, check for abnormalities, and take biopsies if needed to aid in diagnosis.

Indications

• Persistent hoarseness or voice changes
• Difficulty breathing or swallowing
• Chronic cough
• Suspected tumors or growths
• Unexplained throat pain

Preparation

• Fasting for at least 6 hours before the procedure
• Adjustments to regular medications as advised by the physician
• Pre-procedure diagnostic tests like blood work or imaging may be required

Procedure Description

1. The patient is positioned, usually reclining, and receives local anesthesia or general sedation.
2. The laryngoscope is gently inserted through the mouth into the throat to view the larynx (voice box) and the vocal cords.
3. If tracheoscopy is included, further inspection extends into the trachea.
4. The healthcare provider examines the structures, sometimes taking tissue samples (biopsies), and records visual findings.
5. The laryngoscope is removed, and the patient is taken to a recovery area.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

The procedure is usually performed in a hospital, outpatient surgery center, or specialized clinic.

Personnel

• An ENT specialist (Otolaryngologist)
• Nurses
• Anesthesiologist (if general sedation is used)

Risks and Complications

• Sore throat or hoarseness
• Bleeding, especially if a biopsy is taken
• Infection
• Reaction to anesthesia
• Injury to the throat or vocal cords (rare)

Benefits

• Accurate diagnosis of throat and airway conditions
• Potential early detection of serious issues like tumors
• Minimally invasive with quick recovery time

Recovery

• Observation for a short time post-procedure, especially if sedation was used
• Avoid eating or drinking until numbness from anesthesia wears off
• Mild throat discomfort may be managed with pain relievers
• Follow-up appointments to discuss biopsy results or further treatment
• Generally, normal activities can be resumed within a day

Alternatives

• Indirect Laryngoscopy: Less invasive but does not provide as detailed a view
• Imaging tests like CT scans or MRIs: Provide visual details but no direct sampling
• Fiberoptic Laryngoscopy: Less invasive but may not offer the same visual clarity

Patient Experience

During the procedure, the patient may feel some pressure but little to no pain, especially if sedated. Post-procedure, a sore throat and mild discomfort are common, but these usually resolve quickly with appropriate care and pain management.