laryngoscopy

Laryngoscopy is a medical procedure for examining the larynx (voice box) and surrounding structures using a laryngoscope. It allows visualization of the glottis, vocal folds, and laryngeal inlet to diagnose pathology, assess airway patency, and guide therapeutic or diagnostic procedures such as biopsy or intubation.

Direct laryngoscopy uses a rigid blade and light source to lift the tongue and expose the larynx, typically performed under general anesthesia for endotracheal intubation or laryngeal surgery. Indirect laryngoscopy uses a mirror or flexible endoscope to view the larynx without deep anesthesia; awake flexible fiberoptic laryngoscopy is common for evaluating airway, vocal cord function, or dynamic movement.

Techniques and equipment include oral and nasal routes, rigid direct laryngoscopes (such as Macintosh or Miller blades) and flexible or rigid fiberoptic endoscopes, and video laryngoscopes that display the larynx on a monitor. Awake fiberoptic laryngoscopy uses topical anesthesia and, if needed, mild sedation. Preparation involves airway assessment, explanation of risks, and appropriate consent.

Indications encompass evaluation of hoarseness, chronic cough, dysphagia, or stridor; assessment of airway obstruction; preoperative airway evaluation; planning intubation in difficult airway cases; and biopsy or visualization of laryngeal lesions.

Risks and complications may include gagging or coughing, laryngospasm, airway trauma, dental injury, bleeding, infection, and rarely airway compromise. Contraindications are generally relative and depend on patient cooperation, the clinical setting, and specific indications; informed consent and appropriate expertise are essential.