Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique
CPT4 code
Name of the Procedure:
Radiologic Examination of the Pharynx or Larynx Using Fluoroscopy and/or Magnification Technique Common name: Swallowing Study, Fluoroscopic Pharyngeal/Laryngeal Examination
Summary
A radiologic examination of the pharynx or larynx utilizes fluoroscopy and/or magnification techniques to capture real-time moving images of the throat. This helps in evaluating the structure and function of these areas, especially during swallowing.
Purpose
This procedure is used to diagnose issues related to swallowing, breathing, or persistent throat problems. It helps in identifying abnormalities such as obstructions, tumors, structural deformities, or dysfunctions.
Indications
- Difficulty swallowing (dysphagia)
- Chronic cough or throat pain
- Suspected obstructions or tumors
- Voice changes or hoarseness
- Aspiration (food or liquid entering the airway)
- Unexplained weight loss or malnutrition
Preparation
- Patients are usually instructed to fast for several hours before the procedure.
- Removal of any jewelry or metallic objects around the neck and head area.
- A preliminary review of medical history and any current medications.
- No specific diagnostic tests are typically required beforehand, though prior imaging studies may be reviewed.
Procedure Description
- The patient is positioned upright or lying down on an X-ray table.
- A contrast medium (barium) is administered orally to enhance visibility of the pharynx and larynx on the X-ray.
- Fluoroscopy captures real-time moving images as the patient swallows the barium.
- The technician may use various imaging angles and magnifications to thoroughly examine the areas of interest.
- The procedure may include maneuvers such as head tilting to get better views.
- Typically, no anesthesia or sedation is required as the procedure is non-invasive.
Duration
The procedure usually takes about 15 to 30 minutes.
Setting
Performed in a radiology department, either in a hospital or an outpatient imaging center.
Personnel
- Radiologist
- Radiologic technologist
- Speech-language pathologist may also be present in some cases
Risks and Complications
- Exposure to a small amount of radiation.
- Allergic reaction to the contrast medium, though rare.
- Potential for slight discomfort or gagging during the swallowing of barium.
Benefits
- Accurate diagnosis of swallowing and throat-related issues.
- Real-time imaging allows for immediate assessment and potential for corrective measures.
- Non-invasive with minimal discomfort.
Recovery
- No significant recovery time required.
- Patients can typically resume normal activities immediately after the procedure.
- Follow-up appointments may be scheduled to discuss the results and possible treatment plans.
Alternatives
- Manual examination by a physician or ENT specialist.
- Endoscopic examination of the throat.
- MRI or CT scans though these may not provide real-time functional imaging.
- Each alternative has its own pros and cons regarding accuracy, comfort, and complexity.
Patient Experience
During the procedure, the patient may feel a bit awkward or uncomfortable while swallowing the barium. Some patients might find the taste of the contrast medium unpleasant but tolerable. Afterward, there are usually no lingering sensations or effects. The radiologic technologist and other assisting staff will provide guidance and ensure patient comfort throughout the process.