What to Expect During a Laryngoscopy or Pharyngoscopy

Pharyngoscopy

Pharyngoscopy is a procedure that allows your doctor to examine your pharynx, a 5-inch hollow tube that starts behind your nose and goes down the esophagus and trachea.

The pharynx has three parts:

  1. nasal pharynx or nasopharynx - the area located behind the nose
  2. oral pharynx or oropharynx - the soft palate (the back of the mouth), the base of the tongue, and the tonsils
  3. hypopharynx - the lowest part of the pharynx

You will remain awake during the procedure, which can be done in the office. Your doctor will numb your throat and then place a thin, flexible tube (endoscope) inside your nostril and gently guide the tube into your throat. A camera at the end of the tube sends pictures to a video monitor.

Laryngoscopy

Indirect Laryngoscopy
Your doctor will look down your throat using a small, long-handled mirror, looking for abnormalities and to ensure your vocal cords are working correctly. Your doctor will shine a light in your mouth and wear a mirror on his or her head to reflect light to the back of your throat. The test does not hurt. Your doctor may spray a local anesthetic in the back of your throat to stop you from gagging during the procedure.

Direct Laryngoscopy
A laryngoscopy is an examination that uses a fiber optic endoscope, called a laryngoscope, which your doctor will insert through your nose or your mouth. The laryngoscope may be flexible or rigid. The procedure is similar to a pharyngoscopy except the scope goes further and examines the larynx (voice box), vocal cords, and the epiglottis. As the laryngoscope advances, your doctor can look at areas that she/he could not see using just a mirror. If necessary, small tissue samples can be taken for biopsy. A local anesthetic will ease the discomfort and prevent you from gagging. Your doctor may also give you a sedative to help you relax. In some cases, general anesthesia is used, in which case you will not be awake or conscious during the procedure.

Preparation for an Indirect/Flexible Laryngoscopy

Your doctor will give you instructions about not eating or drinking before the examination to prevent vomiting. If you wear dentures, you will be asked to remove them before the examination is done.

Preparation for a Rigid Laryngoscopy (surgical)

Preparation is similar to that of other surgical procedures. Because you will have general anesthesia, do not eat or drink anything for 8 hours before the exam.
Tell your doctor and nurses if you:

  • you have any allergies or are taking any medications
  • or anyone in your family has had problems with general anesthesia in the past
  • have bleeding problems or take medication that interferes with blood-clotting such as Plavix® (clopidogrel), aspirin, Coumadin® (warfarin), Fragmin® (dalteparin), Lovenox® (enoxaparin), Arixtra® (fondaparinux), or any nonsteroidal anti-inflammatory medications (NSAIDs) such Advil® or Motrin® (ibuprofen), Aleve® or Anaprox® (naproxyn), Feldene® (piroxicam), Clinoril ® (sulindac) or Orudis® (ketoprofen)
  •  have heart problems, are or might be pregnant, or are breastfeeding
  • have had surgery or radiation treatments to your mouth or throat

After the Exam

  • If you had a local (spray anesthetic), you can go home and resume your daily activities after the procedure.
  • If you had general anesthesia or if you are sedated during your procedure, you must have a responsible adult available to drive you home after your procedure. Your procedure will be cancelled if you do not have a responsible adult to drive you home. Notify a nurse in the clinic if you have problems making arrangements.
  • After a short recovery period, your doctor will discharge you into the care of a responsible adult. Your discharge and follow-up instructions will be reviewed with you. If you are confused or have questions, please ask; we are here to help. We will give you a copy of your discharge instructions to take home with you.
  • After the anesthetic or sedative wears off, you may have a sore throat for 1 to 3 days.
  • In some cases, depending on your condition, your discharge may be delayed or you may need to be admitted to the hospital.