Laryngoscopy, direct, operative, with biopsy
CPT4 code
Name of the Procedure:
Laryngoscopy, Direct, Operative, with Biopsy
Common Name(s): Direct Laryngoscopy with Biopsy
Technical Terms: Operative Laryngoscopy with Tissue Sampling
Summary
A direct laryngoscopy with biopsy is a medical procedure in which a doctor examines the voice box (larynx) and the surrounding areas using a specialized scope. If abnormal tissues are seen, a biopsy (tissue sample) is taken for further examination.
Purpose
This procedure is used to identify and diagnose abnormalities or diseases of the larynx. It helps detect issues such as vocal cord lesions, cancers, infections, or other structural abnormalities. The goals are to diagnose the underlying cause of symptoms and guide subsequent treatment.
Indications
- Hoarseness or voice changes lasting more than two weeks
- Persistent throat or ear pain
- Difficulty swallowing
- Unexplained coughing or coughing up blood
- Suspected tumors or suspicious lesions in the throat
Preparation
- Fasting for at least 6-8 hours before the procedure.
- Arrangements to stop certain medications, such as blood thinners, as directed by the doctor.
- A pre-operative checkup and possibly imaging studies, like an MRI or CT scan, to guide the procedure.
Procedure Description
- The patient is given general anesthesia to sleep and not feel discomfort during the procedure.
- A laryngoscope—a small instrument with a light and camera—is inserted through the mouth and down the throat to view the larynx.
- The surgeon examines the larynx and may use tools to remove small tissue samples (biopsies) from suspicious areas.
- The scope and any instruments are carefully removed once the examination and tissue collection are complete.
Duration
The procedure typically takes about 30-60 minutes.
Setting
Performed in a hospital or a specialized surgical center equipped with necessary operating room facilities.
Personnel
- ENT (Ear, Nose, and Throat) Surgeon or Otolaryngologist
- Anesthesiologist
- Operating room nurses and surgical technicians
Risks and Complications
- Sore throat and hoarseness
- Difficulty swallowing in the immediate aftermath
- Bleeding where tissue was removed
- Infection
- Anesthesia-related risks such as nausea, vomiting, or allergic reactions
Benefits
- Accurate diagnosis of laryngeal conditions
- Biopsy results guide further treatment, potentially leading to better outcomes
- Relief from symptoms by identifying and treating the root cause
Recovery
- Patients are usually observed for a few hours post-procedure before being discharged.
- Soft or liquid diet recommended for 24-48 hours.
- Rest the voice for several days to prevent strain.
- Follow-up appointments to discuss biopsy results and next steps.
Alternatives
- Indirect laryngoscopy, less invasive but might not be as thorough.
- Imaging tests like MRI or CT scans, non-invasive but cannot provide tissue samples.
- Stroboscopy, a type of indirect laryngoscopy ideal for vocal cord vibration analysis.
Patient Experience
The patient will be under general anesthesia, so they won't feel anything during the procedure. Post-procedure, there may be mild discomfort, sore throat, and hoarseness. Pain management strategies and follow-up care are provided to ensure a comfortable recovery period.