Laryngoscopy – what it is, how it’s performed?
Hypopharynx – on, which often becomes inflamed or tumor localization. However, diagnosis of pathology of the hypopharynx is difficult due to anatomical features of the organ. Diseases of the throat, larynx and other structures of this region are determined only by using special methods of research.
For this purpose there is a direct and indirect laryngoscopy. It is carried out the doctors and otolaryngologists, as well as by … doctors, dealing with the problems of the ligaments. Laryngoscopy today: what is it?
The method and its possibilities
There are several varieties laryngoscopy. It is performed to rule out various diseases. What pathology of the larynx, hypopharynx and larynx can be detected by laryngoscopy (direct or indirect) of the larynx?
- Laryngitis, especially chronic, with the expansion of the subglottic tissue.
- Croup in children, including about.
- Swelling of the subglottic space (important for the baby, as this condition can cause asphyxia from patients from the children’s profile).
- Polyps and other endometrial, which is very important for people whose profession is associated with spoken word, singing, teaching, lecturing.
- Cancer education.
Technology method is owned by all otolaryngologists. The procedure itself is relatively safe, therefore, contraindications to its conduct virtually no.
What is laryngoscopy? This examination of the hypopharynx with the help of special instruments (laryngeal mirrors, laryngoscope).
The technique is not only diagnostic, but also therapeutic, like any other endoscopy.
Indications for laryngoscope study
For a consultation with the ENT doctor can be booked independently. Sometimes it can direct a therapist. Indications for study are:
- Problems with the voice. It is very important not only for teachers, musicians, speakers, lecturers, but also for those whose professional activity does not require high voice load. Patients complain that their voice has become husky or a rougher timbre. Aphonia is sometimes observed. We are talking about a situation when the voice is lost completely. In any case, you should contact Laura for conducting a laryngoscopy to identify and eliminate possible causative factor.
- Violation of act of swallowing. The patient may complain of discomfort when swallowing, inability to swallow from a solid or semi-liquid food. Laryngoscope study was carried out to exclude pathology of the hypopharynx.
- Pain in the throat. This is another reason to do the study. Not always a culprit of this symptom is a lesion of the mucosa of the pharynx. Should be deleted and diseases of the larynx.
- Cancer of the larynx. In older patients the appearance of malignant tumors is not the rare phenomenon today. Tar, nicotine, air pollution, infection with viruses, the factors that contribute to the developmental processes of the mucous membrane of the hypopharynx. So any discomfort in the mouth, choking, change in voice, dryness in the elderly should alert the doctor of any specialty and become the reason for the referral to the otorhinolaryngologist to exclude a malignant tumor.
Ear canal with the pharyngeal cavity connected by the Eustachian tube. Her pathology (inflammation, called Eustachian) can also be identified during the laryngoscopy. But the diagnosis in these cases is difficult.
What other opportunities exist when performing laryngoscopy, including children?
- A sample of tissue (biopsy) for histological examination to verify the diagnosis;
- Cure for polyps on his vocal cords and scarring, deformation;
- Removal of foreign body;
- Attempt to open the abscess retropharyngeal space.
Thus, when performing a laparoscopy not only the diagnosis but also the treatment of the disease.
Otherwise the name of the method is indirect laryngoscopy. To implement this research, as the name implies, requires special laryngeal mirror. The second important ingredient is the lighting. For him, use a reflector (usually frontal). It is necessary in order to reflect the light from the lamp.
How to conduct mirror laryngoscopy? The prerequisite is considered to be a darkened room. The lamp should be positioned to the right relative to the examined patient. Laryngeal mirror before the procedure should be heated to the temperature of the human body. It is important to observe in order to avoid spasm of the muscles of the hypopharynx, as well as condensation on the glass that will hinder visibility.
Next, the following steps are performed:
- The doctor fixes the patient’s open mouth, keeping the tongue and if necessary, raises upper lip.
- If you adjust the light directed into the oral cavity of the patient (in the area of curtains, arches), introduces the laryngeal mirror. To keep his doctor needs as a ballpoint pen.
- To facilitate inspection of the hypopharynx, the patient is asked to pronounce the sounds of «And» and «uh». But this technique does not always work. Sometimes doctors have to push the tissue of the soft palate to the back wall of the oropharynx. To prevent the gag reflex, it is possible to irrigate the oral cavity produces the anasthetic substances.
The essence of the study is that light from the reflector is reflected and goes straight to the larynx. The handle of the mirror should not close the review for consultation (to the left of the corner of his mouth).
The picture before the consultation opens semi. This means that the right and left of the space retain their orientation, but the back office is visible from the front and Vice versa.
Mainly pay attention to the condition of the ligaments.
Should assess their symmetry, color, texture, closing. Sometimes it is possible to see the trachea. After the study, the doctor records your scores in the card or Protocol manipulation.
Orthoscope and retrograde laryngoscopy
The direct method of laryngoscopy is performed using endoscopic instruments – laryngoscope. Replacement blades, tips allow you to approach the question from an anatomical point of view, and individual characteristics of the organism. The study required the preparation and conduct of anesthesia (surface).
Retrograde laryngoscopy is used in the presence of a tracheostomy. This method also assumes the presence of the reflector, the mirror is inserted into the region tracheostomy hole. Microlaryngoscopy research necessary for a more detailed consideration of the mucosa. It necessitates the use of a microscope when orthoscope or mirror laryngoscopy.
The choice of research method is performed by the doctor depending on the clinical situation and characteristics of the patient.
Situation when laryngoscopy should not be implemented because of the potentially greater harm compared to benefit, are few.
- Severe somatic pathology in the stage of decompensation. This severe angina: progressive, hemodynamic, and malignant hypertension, valvular disease, aneurysmal expansion of the vessel. This group of contraindications include severe respiratory distress and decompensated diabetes.
- Pathology of the oropharyngeal zone (erosive glossitis, stomatitis, gingivitis). Erosion represent defects of the mucous membrane of the body. They are dangerous emergence of bleeding. Even more dangerous ulcerative changes.
Laryngoscopy, despite the simplicity of implementation and low cost, remains one of the most important methods of diagnosis of pathology of the larynx and pharynx. Of course, much depends on the experience and qualifications of the specialist performing the study. It makes the study subjective. But with questionable results, you can always use more advanced methods – ultrasonic method and tomography.