Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording
CPT4 code
Name of the Procedure:
Flexible Endoscopic Evaluation, Laryngeal Sensory Testing by Cine or Video Recording
Summary
Flexible endoscopic evaluation with laryngeal sensory testing is a medical procedure that uses a flexible tube with a camera (endoscope) to examine the throat and vocal cords. This particular form of endoscopy includes tests to evaluate the sensitivity of the laryngeal area. The procedure can be video-recorded for detailed analysis.
Purpose
The procedure is used to diagnose and assess various throat and vocal cord disorders, such as swallowing difficulties, chronic cough, or voice problems. It aims to detect abnormalities in the larynx and measure its sensory responses to recommend appropriate treatments.
Indications
- Difficulty swallowing (dysphagia)
- Chronic cough
- Persistent hoarseness or voice changes
- Suspected vocal cord dysfunction
- Unexplained throat discomfort
Preparation
- Patients may be instructed to fast for a few hours before the procedure.
- Adjustments to medications may be necessary; particularly anticoagulants.
- A brief medical history and a physical examination will be conducted prior.
Procedure Description
- The patient is seated comfortably in a chair.
- A topical anesthetic is sprayed into the nose and throat for comfort.
- A flexible endoscope is gently inserted through the nose to reach the larynx.
- Sensory testing is conducted by applying air pulses to the larynx to assess responsiveness.
- The entire process is video recorded for further analysis.
- Throughout the procedure, visual images of the larynx are observed on a monitor.
Duration
The procedure typically takes about 15 to 30 minutes.
Setting
The procedure is usually performed in an outpatient clinic or a hospital-based ENT (Ear, Nose, and Throat) department.
Personnel
- Otolaryngologist (ENT specialist)
- Medical assistant or nurse
Risks and Complications
- Minimal discomfort or gagging
- Rare nosebleeds
- Transient sore throat
- Rare risk of infection
Benefits
- Accurate diagnosis of laryngeal and vocal cord conditions
- Identification of sensory deficits or abnormalities
- Video recording allows detailed review and accurate treatment planning
- Non-invasive and quick recovery
Recovery
- Patients can usually resume normal activities immediately after the procedure.
- Mild throat soreness may occur but typically resolves within a few hours.
- Follow-up appointments may be scheduled based on findings.
Alternatives
- Rigid endoscopy: A more invasive method requiring general anesthesia.
- Imaging studies: Such as MRI or CT scans, less specific for laryngeal sensory function.
- Clinical assessment: Less detailed without visual confirmation.
Patient Experience
During the procedure, patients may experience mild discomfort or a gagging sensation as the endoscope is introduced. Afterward, there may be slight soreness in the throat, which can be managed with simple pain relievers and throat lozenges. Most patients find the procedure tolerable and appreciate the benefits of detailed and accurate diagnosis.