Laryngoscopy is a visual examination below the back of the throat, where the voice
box (larynx) containing the vocal cords is located. It helps doctors identify the
causes of voice and breathing problems, throat or ear pain, difficulty in swallowing,
narrowing of the throat (strictures or stenosis), and airway blockages.
Laryngoscopy is relatively painless, but the idea of having a scope inserted into
the throat can be a little scary for kids, so it helps to understand how a laryngoscopy
Ear, nose, and throat specialists (also called ENT doctors or otolaryngologists)
do laryngoscopies. The three kinds of laryngoscopy are:
The indirect procedure can be performed in a doctor's office using a small hand
mirror held at the back of the throat. The doctor will aim a light at the back of
the throat, usually by wearing headgear that has a bright light attached, to examine
the larynx and vocal cords. Indirect laryngoscopy is not typically used with kids
because it tends to cause gagging.
Flexible and direct laryngoscopy examinations allow doctors to see deeper into
the throat by using either a flexible or rigid telescope. Rigid telescopes are
more often used as part of a surgical procedure in evaluating kids with stridor
(a noisy, harsh breathing) and removing foreign objects in the throat and lower airway.
They're also used in collecting tissue samples (biopsies), laser treatments, and in
locating cancer of the larynx.
Why Is Laryngoscopy Performed?
Laryngoscopy is performed to:
diagnose a constant cough, throat pain, bleeding, hoarseness, or constant bad
check for inflammation (swelling and irritation)
discover a possible narrowing or blockage of the throat
remove foreign objects, such as small toys swallowed by mistake
see or get a sample of a mass or tissue in the throat or on the vocal cords
diagnose swallowing problems
diagnose suspected cancer
evaluate causes of persistent earache
diagnose voice problems, such as weak voice, hoarse voice, breathy voice, or no
Talk to your doctor about the kind of test being performed, how it will be done,
the risks, and the results. Having your questions answered beforehand will help reduce
your concerns and give you and your child a better understanding of how the procedure
After examining a child, a doctor might recommend a chest
X-ray or CT scan (a type of X-ray that uses a computer to take pictures of
the inside of the body). Your child also might be asked to swallow a liquid called
barium while a series of X-rays of the larynx and esophagus are taken. Barium liquid
is harmless and will pass through the body within a day or two. These tests will help
your doctor further understand the physical symptoms your child is having.
For an office laryngoscopy that uses local anesthesia, it is okay
for your child to eat or drink beforehand.
If general anesthesia will be used, your doctor may not want your
child to eat or drink for a few hours before the exam (this is to prevent vomiting).
Indirect laryngoscopy and flexible laryngoscopies often are performed in the doctor's
office, usually using local anesthetic. They usually take only 5 to 10 minutes.
Indirectlaryngoscopy will require your child
to sit up straight in a high-backed chair with a headrest and open his or her mouth
wide. The doctor will spray the throat with an anesthetic or numbing medication (which
your child will gargle and spit out), then cover the tongue with gauze and hold it
The doctor will hold up a warm mirror to the back of the throat and, with a light
attached to his or her headgear, will tilt the mirror to view various areas of the
throat. Your child may be asked to make high-pitched or low-pitched sounds so that
the doctor can view the larynx and see the vocal cords move.
Flexible laryngoscopy uses a flexible laryngoscope (a thin, flexible
instrument that lights and magnifies images) for a better view of the larynx and vocal
This might be done in an operating room under general anesthesia or in the doctor's
office, and usually doesn't require a hospital stay. The flexible scope is inserted
through a nostril or the mouth, then the doctor examines the throat area through the
scope's eyepiece. Sometimes the images are displayed on a monitor so that family members
can see what the doctor is seeing.
Direct laryngoscopy is done in an operating room and your child
will be put under general anesthesia and not feel the scope in the throat. If needed,
the doctor will remove foreign objects from the throat, collect tissue samples, perform
laser treatment, or remove growths from the vocal cords. This can take as little as
15 to 30 minutes, but might take much longer if specific treatments are required.
After the Procedure
If a local anesthetic or topical numbing spray was used, it will wear off in about
30 minutes. Your child should not eat or drink anything until the spray has worn off
and the throat is no longer numb.
After a direct laryngoscopy, your child will be watched by a nurse until fully
awake and able to swallow. This usually takes about 2 hours. In some cases, an overnight
hospital stay may be required. Your child may have some nausea, general muscle aches,
and feel tired for a day or two.
Gargling and sucking on throat lozenges will help with the soreness. You can also
give pain medication according to your doctor's recommendations, if needed. Your child
may sound hoarse or have noisy breathing for a few days after the procedure. This
is normal. If the hoarseness persists or your child has difficulty breathing, contact
The doctor will explain the findings after the procedure. If a biopsy was taken,
a laboratory will examine the tissue and report the results to your doctor, who will
discuss the results and treatment options with you. Usually, biopsy results take about
3 to 5 days.
Depending on the outcome of the exam, your doctor might schedule an office visit
or a follow-up procedure for 4 to 6 weeks after the initial laryngoscopy.
When your child is having any kind of procedure, it's understandable to be a little
uneasy. But it helps to know that a laryngoscopy is considered an extremely effective
and routine medical exam and complications are rare. However, as with most procedures,
there are some risks, which your doctor will review with you. If you have any questions
about laryngoscopy, speak with your doctor.