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Direct Laryngoscopy
Direct Laryngoscopy is a diagnostic procedure, but may also be therapeutic if removal of a foreign body, cyst, nodule, polyp or tumor is performed. It also is a way to improve vocal quality by injecting biocompatible agents (i.e. gelfoam, fat, collagen, etc.) that amplify one's voice. This is called injection laryngoplasty. When the cause of the complaint remains unidentified after mirror or flexible laryngoscopy, a direct laryngoscopy is performed. Direct laryngoscopy is a frequently performed otolaryngologic procedure and considered to be one of the safest. Among the few complications that may occur are injury to teeth, risks of general anesthesia, bleeding after biopsy, and failure of a vocal cord to heal after biopsy. Voice change or hoarseness is possible after vocal cord surgery.
Procedure
Direct laryngoscopy is a brief procedure done with a microscope and/or laser. The lesion is identified and removed microscopically and sent to pathology for analysis. You will be asked to come into the Center about an hour prior to the procedure to get ready. You will talk with a nurse (who will start an IV), anesthesiologist and Dr. Coniglio before the procedure. It takes about an hour, with about a one-half hour recovery time. You will be discharged about two hours thereafter.
Following your procedure we will ask you to avoid whispering, just to say brief, short answers (yes or no) and talk only to those within arm's length. We ask you to avoid clearing your throat, but it will be difficult because you will have a sore throat for about 24 hours. You may resume eating with soft foods and liquids at first, progressing to regular food the next day. If you are on an anti-reflux therapy continue it aggressively after surgery.
Care will be taken not to harm your lips or teeth. Postoperatively, patients complain of swollen lips and that their tongue feels a bit full or numb. If there are any problems with your breathing after surgery we will keep you overnight. However, that is extremely rare, as 99% of patients go home following this procedure.
Postoperatively, you will be asked to follow voice rest as indicated on the laryngoscopy instruction sheet. We will follow up with you in the office for a repeat video endoscopy in about three to four weeks postoperatively. Knowing that you may have a sensitive gag reflex, we will take extra care. You should rest your voice for one month and you can resume singing following one month of voice rest: Remember that absolute voice rest for five days postoperatively is essential to healing. Once again, avoid throat clearing, drink lots of fluids and avoid coughing if possible. The pathology report will be back no sooner than one week. We will call you with the results.
Pre-Operative Instructions
Nothing to eat or drink after midnight the evening before the procedure. This includes all food, liquids, water, candy, mints or gum. Your procedure will be cancelled if you do not follow these instructions.
- Take medications as directed with just a sip of water in the a.m.
- Please avoid any aspirin, aspirin-containing products, or ibuprofen (Advil®, Aleve®, etc.) for one week prior to your surgery. If you are on any medications that affect bleeding (such as coumadin or warfarin) please notify the office immediately.
- Do not bring valuables (cash, credit cards, watches, jewelry, etc.) to the center. Remove make-up and nail polish before coming to the procedure center.
- Please call Westfall Surgery Center at 256-3862 before noon on the day prior to your procedure to confirm your arrival time
Post-Operative Instructions
Maintain complete voice rest for five to seven days. If you must speak, do not whisper or talk loudly. Vocal hygiene parameters (see printed sheet given to you in the office during your preoperative visit) should be observed once you resume voice use. If you find you must speak during the first seven days following this procedure, do so but use a normal voice for a very short period of time. DO NOT whisper.
- Avoid heavy lifting, bending or straining for one week. Otherwise, resume normal activity on the day following your procedure.
- Advance diet from liquids to soft food to solids as tolerated. Avoid hot liquids or food. You may experience a sore throat following this procedure so you may find liquids and soft foods are more comfortable the first few days
- Resume all preoperative medications as prior to your procedure. You should not require any special medications following this procedure. You may wish to take Tylenol® or Advil® for post-procedure discomfort.
- Notify the office for any of the following:
- difficulty breathing or painful swallowing
- loose or dislodged teeth
- significant swelling of the neck or back of throat
- coughing up blood or persistent bleeding (You may notice some slight blood-tinged sputum which is not uncommon.)
Pathology results are typically available within seven days following your procedure. These results will be telephoned to you. Your follow-up appointment should be scheduled for three to four weeks following your procedure. Please telephone the office after one week if you have not heard the results of biopsy or for a follow-up plan.
For an emergency please call our professional answering service at 585-258-4840.
Please notify the office 585-256-3550 for any concerns. We are here to help in any way we can.
Dr. John U. Coniglio and Staff
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