Laryngoscopy and nasolarynoscopy
Laryngopharyngoscopy; Indirect laryngoscopy; Flexible laryngoscopy; Mirror laryngoscopy; Direct laryngoscopy; Fiberoptic laryngoscopy; Laryngoscopy using strobe (laryngeal stroboscopy)
Laryngoscopy is an exam of the back of your throat, including your voice box (larynx). Your voice box contains your vocal cords and allows you to speak.
How the Test is Performed
Laryngoscopy may be done in different ways:
- Indirect laryngoscopy uses a small mirror held at the back of your throat. The health care provider shines a light on the mirror to view the throat area. This is a simple procedure. Most of the time, it can be done in the provider's office while you are awake. A medicine to numb the back of your throat may be used.
- Fiberoptic laryngoscopy (nasolaryngoscopy) uses a small flexible telescope. The scope is passed through your nose and into your throat. This is the most common way that the voice box is examined. You are awake for the procedure. Numbing medicine will be sprayed in your nose. This procedure typically takes less than 1 minute.
- Laryngoscopy using strobe light can also be done. Use of strobe light can give the provider more information about problems with your voice box.
- Direct laryngoscopy uses a tube called a laryngoscope. The instrument is placed in the back of your throat. The tube may be flexible or stiff. This procedure allows the doctor to see deeper in the throat and to remove a foreign object or sample tissue for a biopsy. It is done in a hospital or medical center under general anesthesia, meaning you will be asleep and pain-free.
How to Prepare for the Test
Preparation will depend on the type of laryngoscopy you will have. If the exam will be done under general anesthesia, you may be told not to drink or eat anything for several hours before the test.
How the Test will Feel
How the test will feel depends on which type of laryngoscopy is done.
Indirect laryngoscopy using a mirror or stroboscopy can cause gagging. For this reason, it is not often used in children under age 6 to 7 or those who gag easily.
Fiberoptic laryngoscopy can be done in children. It may cause a feeling of pressure and a feeling like you are going to sneeze.
Why the Test is Performed
This test can help your provider diagnose many conditions involving the throat and voice box. Your provider may recommend this test if you have:
- Bad breath that does not go away
- Breathing problems, including noisy breathing (stridor)
- Long-term (chronic) cough
- Coughing up blood
- Difficulty swallowing
- Ear pain that does not go away
- Feeling that something is stuck in your throat
- Long-term upper respiratory problem in a smoker
- Mass in the head or neck area with signs of cancer
- Throat pain that does not go away
- Voice problems that last more than 3 weeks, including hoarseness, weak voice, raspy voice, or no voice
A direct laryngoscopy may also be used to:
- Remove a sample of tissue in the throat for closer examination under a microscope (biopsy)
- Remove an object that is blocking the airway (for example, a swallowed a marble or coin)
A normal result means the throat, voice box, and vocal cords appear normal.
What Abnormal Results Mean
Laryngoscopy is a safe procedure. Risks depend on the specific procedure, but may include:
- Allergic reaction to anesthesia, including breathing and heart problems
- Major bleeding
- Spasm of the vocal cords, which causes breathing problems
- Ulcers in the lining of the mouth/throat
- Injury to the tongue or lips
Indirect mirror laryngoscopy should NOT be done:
- In infants or very young children
- If you have acute epiglottitis, an infection or swelling of the flap of tissue in front of the voice box
- If you cannot open your mouth very wide
Armstrong WB, Vokes DE, Verma SP. Malignant tumors of the larynx. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 106.
Hoffman HT, Gailey MP, Pagedar NA, Anderson C. Management of early glottic cancer. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 107.
Mark LJ, Hillel AT, Herzer KR, Akst SA, Michelson JD. General considerations of anesthesia and management of the difficult airway. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 5.
Truong MT, Messner AH. Evaluation and management of the pediatric airway. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 202.
Wakefield TL, Lam DJ, Ishman SL. Sleep apnea and sleep disorders. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 18.
Last reviewed on: 8/12/2019
Reviewed by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.