Name of the Procedure:

Laryngoscopy, Flexible; with Biopsy(ies)

Summary

A flexible laryngoscopy with biopsy is a medical procedure that involves using a thin, flexible tube with a light and camera (laryngoscope) to view the throat and voice box (larynx). During this procedure, tissue samples (biopsies) may be taken for further examination.

Purpose

This procedure helps diagnose issues related to the throat or voice box, such as infections, inflammation, tumors, or vocal cord issues. The laryngoscope allows doctors to see abnormalities, and biopsy samples help determine whether there are any malignancies or other serious conditions.

Indications

• Persistent hoarseness or voice changes
• Difficulty swallowing
• Chronic throat pain
• Unexplained bleeding from the throat
• Suspicion of throat cancer
• Vocal cord paralysis
• Frequent coughing or throat clearing

Preparation

• Fasting: Patients may be instructed not to eat or drink for several hours before the procedure.
• Medication: Specific instructions will be provided regarding which medications to take or avoid.
• Pre-procedure assessment: Check-up and possibly blood tests or imaging studies.

Procedure Description

1. Preparation: The patient is positioned comfortably and may receive a local anesthetic to numb the throat.
2. Insertion: The flexible laryngoscope is gently inserted through the nose or mouth.
3. Examination: The doctor views the larynx and other throat structures.
4. Biopsy: If abnormalities are found, small tissue samples are taken using tiny tools passed through the laryngoscope.
5. Completion: The laryngoscope is carefully removed.

Tools: Flexible laryngoscope, light source, camera, biopsy tools.

Anesthesia: Local anesthesia (numbing spray); sedation may be used in some cases.

Duration

The procedure typically takes around 30 minutes.

Setting

Usually performed in an outpatient clinic or hospital.

Personnel

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

Risks and Complications

• Sore throat or discomfort post-procedure
• Bleeding at the biopsy site
• Risk of infection
• Rarely, vocal cord injury

Benefits

• Accurate diagnosis of throat and voice box conditions
• Early detection of potential malignancies
• Appropriate treatment planning based on biopsy results

Recovery

• Post-procedure care: Rest the voice, avoid straining the throat, and follow dietary recommendations.
• Immediate recovery: Few hours; most patients can resume normal activities the next day.
• Restrictions: Avoid strenuous activities and certain foods/drinks as instructed.
• Follow-up appointments: To discuss biopsy results and further treatment if necessary.

Alternatives

• Rigid laryngoscopy (requires general anesthesia, different scope)
• CT or MRI scans (less detail of surface tissues)
• Observation and medical management without biopsy

Pros and Cons of Alternatives:

• Rigid laryngoscopy: More invasive but might provide better access for biopsy.
• Imaging scans: Non-invasive but may miss some surface abnormalities.

Patient Experience

During the procedure, patients might feel mild discomfort, pressure, or the urge to cough. Post-procedure, there may be a temporary sore throat. Pain management includes over-the-counter pain relievers and soothing measures like throat lozenges.