Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral
CPT4 code
Name of the Procedure:
Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral
Common name(s): Flexible laryngoscopy with laser ablation
Summary
A flexible laryngoscopy with laser ablation is a medical procedure that uses a flexible scope and laser technology to examine the larynx (voice box) and remove or destroy abnormal lesions on one side of the larynx.
Purpose
The procedure addresses conditions such as benign or malignant lesions, vocal cord polyps, cysts, or other abnormal growths in the larynx. The goals are to remove the lesions, improve breathing and voice quality, and prevent further complications.
Indications
- Persistent hoarseness or voice changes
- Difficulty breathing
- Suspected or confirmed benign or malignant lesions in the larynx
- Recurrent respiratory papillomatosis
- Chronic cough or throat pain
Preparation
- Patients may be instructed to fast for 6-8 hours before the procedure.
- Medication adjustments, especially blood thinners, may be necessary.
- Diagnostic tests such as imaging studies or a biopsy may be conducted beforehand.
Procedure Description
- The patient is usually sedated or given local anesthesia.
- A flexible laryngoscope is inserted through the nose or mouth to visualize the larynx.
- A laser device is used through the scope to precisely ablate or destroy the identified lesions.
- The scope and laser are then carefully removed.
Duration
The procedure typically takes 30-60 minutes.
Setting
This procedure is usually performed in an outpatient clinic, hospital, or surgical center.
Personnel
- ENT (ear, nose, and throat) surgeon or laryngologist
- Nurses
- Anesthesiologist or nurse anesthetist (if general anesthesia is used)
Risks and Complications
- Bleeding
- Infection
- Swelling or airway obstruction
- Change in voice quality
- Damage to surrounding tissues or structures
Benefits
- Improved breathing and voice quality
- Effective removal of lesions
- Quick recovery time, often allowing same-day discharge
Recovery
- Patients may experience a sore throat and mild discomfort, managed with pain medications.
- Voice rest is often recommended for a few days.
- Expect a recovery period of 1 to 2 weeks.
- Follow-up appointments are necessary to monitor healing and ensure lesions are completely removed.
Alternatives
- Traditional laryngoscopy with cold instruments
- Radiation therapy (for malignant lesions)
- Observation or medical management for small, asymptomatic lesions
- Surgery with a rigid scope
Pros and Cons of Alternatives:
- Traditional laryngoscopy is more invasive but may be necessary for larger lesions.
- Radiation therapy is non-invasive but has long-term side effects.
- Observation avoids procedural risks but may allow lesions to grow.
Patient Experience
Patients might feel some discomfort or a gagging sensation during the procedure. Post-procedural pain is generally mild and manageable with medications. Voice rest and avoiding strenuous activities are often advised to ensure optimal healing.