Name of the Procedure:

Laryngoscopy Direct with or without Tracheoscopy; with Dilation, Initial

Summary

Direct laryngoscopy with or without tracheoscopy involves the use of a specialized scope to visualize the larynx (voice box) and trachea (windpipe). This procedure includes the initial dilation (widening) of these structures to treat obstructions or strictures.

Purpose

This procedure addresses conditions that cause narrowing or blockages in the larynx or trachea, such as stenosis (abnormal narrowing) or scarring. The primary goal is to improve breathing and airflow by dilating the constricted areas.

Indications

• Symptoms such as difficulty breathing, wheezing, or stridor (noisy breathing)
• Diagnosed tracheal or laryngeal stenosis
• Previous medical imaging or endoscopic findings indicating narrowing of the airway

Preparation

• Fasting for several hours before the procedure, typically overnight
• Adjustments to medications as instructed by the physician (e.g., blood thinners)
• Pre-procedure diagnostic tests such as imaging studies or pulmonary function tests

Procedure Description

1. The patient is placed under general anesthesia to ensure comfort and immobility.
2. A laryngoscope or tracheoscope is carefully inserted through the mouth to visualize the larynx and trachea.
3. If a narrowing is identified, dilation is performed using specialized balloons or instruments to widen the airway.
4. The scope is withdrawn, and the patient's airway and breathing are monitored for stability.

Duration

The procedure usually takes 30 minutes to 1 hour, depending on the complexity.

Setting

Performed in a hospital operating room or a specialized outpatient surgical center.

Personnel

• Otolaryngologist (ENT specialist) or thoracic surgeon
• Anesthesiologist
• Assisting nurses and surgical technicians

Risks and Complications

• Common risks: sore throat, temporary hoarseness, and mild bleeding
• Rare risks: airway injury, infection, severe bleeding, or adverse reaction to anesthesia
• Complication management includes monitoring and treating symptoms post-procedure.

Benefits

• Improved breathing and alleviation of symptoms caused by airway obstruction.
• Benefits are often realized immediately or within a few days after the procedure.

Recovery

• Monitoring in a recovery area until the patient is awake and stable
• Instructions for rest and activity limitations for a few days
• Follow-up appointments to assess the success of the dilation and overall airway health

Alternatives

• Medications to manage inflammation or underlying conditions causing the narrowing
• Less invasive procedures such as in-office balloon dilation (suitable for mild cases)
• Surgical reconstruction for severe or structural airway abnormalities

Patient Experience

• Under anesthesia, the patient will not feel or remember the procedure.
• Post-procedure, the patient may experience a sore throat, mild discomfort, or hoarseness, managed with pain relievers as needed.
• Gradual return to regular activities over a few days, with close observation for any breathing difficulties or complications.