Name of the Procedure:

Laryngoscopy, flexible; with therapeutic injection(s) (e.g., chemodenervation agent or corticosteroid, injected percutaneously, transorally, or via endoscope channel), unilateral Common Name: Flexible Laryngoscopy with Therapeutic Injections

Summary

Flexible laryngoscopy with therapeutic injections is a procedure where a thin, flexible tube equipped with a camera (laryngoscope) is used to view the throat and voice box (larynx). During this procedure, medications such as chemodenervation agents or corticosteroids are injected to address specific conditions affecting the larynx.

Purpose

This procedure addresses medical conditions affecting the larynx, such as vocal cord paralysis, inflammation, spasms, or other abnormalities. The goals are to improve voice quality, reduce pain, inflammation, or spasms, and restore normal function to the vocal cords.

Indications

• Hoarseness or voice changes
• Difficulty swallowing
• Throat pain or discomfort
• Suspected vocal cord paralysis or spasms
• Persistent cough or throat clearing Patients who have tried less invasive treatments without success may be candidates for this procedure.

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted.
• Diagnostic tests such as imaging studies or voice assessments may be required prior to the procedure.

Procedure Description

1. The patient may be given a local anesthetic to numb the throat.
2. The flexible laryngoscope is gently inserted through the nose or mouth to view the larynx.
3. Therapeutic injections, such as chemodenervation agents or corticosteroids, are administered percutaneously, transorally, or via the endoscope channel to the targeted area of the larynx.
4. The laryngoscope is carefully removed once the injections are complete. This procedure may involve the use of a camera, light source, and specialized needles or catheters.

Duration

The procedure typically takes about 20 to 30 minutes.

Setting

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

Personnel

• Otolaryngologist (ENT doctor)
• Nurse or medical assistant
• Anesthesiologist (if sedation is used)

Risks and Complications

• Infection
• Bleeding
• Swelling or bruising
• Allergic reaction to the medications used
• Temporary or permanent changes in voice quality

Benefits

• Improved voice quality and function
• Reduced pain and inflammation
• Decreased muscle spasms
• Relief from symptoms usually realized within a few days to weeks.

Recovery

• Patients may experience mild throat discomfort after the procedure.
• Voice rest is often recommended for a few days.
• Follow-up appointments may be necessary to monitor progress.
• Normal activities can typically be resumed within a day or two, but patients should avoid strenuous activities until cleared by their doctor.

Alternatives

• Voice therapy
• Oral or injectable medications
• Surgery (e.g., laryngeal framework surgery)
• Pros and cons of alternatives should be discussed with the healthcare provider to determine the best treatment option.

Patient Experience

• The patient may feel mild discomfort or a gagging sensation during laryngoscope insertion
• Post-procedure, throat soreness and mild pain are common.
• Pain management may include over-the-counter pain relievers or prescription medications as needed.
• Efforts will be made to ensure patient comfort throughout the procedure.