Laryngoscopy, Flexible Fiberoptic, with Injection into Vocal Cord(s), Therapeutic, Including Diagnostic Laryngoscopy (C9742)

Name of the Procedure:

Common Names: Flexible Laryngoscopy with Vocal Cord Injection
Technical Terms: Laryngoscopy, flexible fiberoptic, with injection into vocal cord(s), therapeutic

Summary

Flexible laryngoscopy with vocal cord injection is a procedure where a thin, flexible tube with a camera (laryngoscope) is passed through the nose or mouth to visualize the vocal cords. During the same procedure, a therapeutic injection is administered directly into the vocal cords to treat specific disorders.

Purpose

This procedure addresses various vocal cord issues, including lesions, scarring, paralysis, and certain benign growths. It aims to improve voice quality, alleviate symptoms of vocal cord disorders, and, in some cases, restore normal vocal function.

Indications

• Persistent hoarseness or voice changes
• Vocal cord paralysis or paresis
• Benign vocal cord lesions such as cysts or polyps
• Scarring or restricted movement of the vocal cords
• Voice therapy that has not yielded sufficient improvement

Preparation

• Patients often need to fast for several hours before the procedure.
• Specific instructions regarding the use of current medications, particularly blood thinners or anti-inflammatory drugs, will be provided.
• Pre-procedure assessments may include voice evaluations and imaging tests like CT scans or MRIs.

Procedure Description

1. A topical anesthetic is applied to the throat area.
2. A thin, flexible laryngoscope is gently inserted through the nose or mouth to visualize the vocal cords.
3. The physician examines the vocal cords and surrounding structures.
4. If therapeutic injection is needed, a fine needle is used to inject medication directly into the vocal cords under the guidance of the laryngoscope.
5. The laryngoscope is withdrawn, and the patient is monitored for a short period.

Tools Used: Flexible laryngoscope, injectable medication, fine needle.
Anesthesia: Local anesthesia (topical), with or without mild sedatives.

Duration

The entire procedure typically takes about 30 minutes to 1 hour.

Setting

The procedure is usually performed in an outpatient clinic or a specialized surgical center.

Personnel

• Otolaryngologist (ENT specialist) or surgeon
• Nurse and possibly an anesthesiologist if sedation is used

Risks and Complications

• Mild discomfort or soreness in the throat
• Temporary hoarseness or voice changes
• Bleeding or infection at the injection site (rare)
• Allergic reactions to anesthetic or medication

Benefits

• Improved vocal function and quality
• Relief from symptoms such as hoarseness and difficulty speaking
• Potential restoration of normal voice in cases with vocal cord paralysis

Recovery

• Patients may experience mild throat discomfort for a few days.
• Voice rest is recommended for several days post-procedure.
• Follow-up appointments to monitor progress and voice assessments as needed.
• Most patients can return to normal activities within a day or two, though heavy voice use should be avoided initially.

Alternatives

• Voice therapy and vocal exercises
• Laser surgery for certain benign lesions
• Open or endoscopic vocal cord surgery
• Each alternative has its own risk and benefit profile and may be more or less suited based on the individual patient's condition.

Patient Experience

Patients might feel mild discomfort during the insertion of the laryngoscope and slight pressure during the injection. Post-procedure, throat soreness is common and usually resolves within a few days. Pain management will typically involve over-the-counter pain relievers and measures like throat lozenges and adequate hydration to improve comfort.