What is direct laryngoscopy?
Direct laryngoscopy is a direct visualization of the different parts of the larynx and hypopharynx.
What are the indications for direct laryngoscopy?
- When indirect laryngoscopy is not possible for example, in young children and infants for laryngeal lesions like stridor.
- Vocal cord paralysis.
- Extent of the growth in cases carcinoma of the vocal cords and to take a biopsy.
- As a part of panendoscopy in cases of unknown primary with cervical metastasis.
- Excision of benign lesions of the larynx such as papilloma, vocal nodules or cyst.
- Insertion of laryngeal stent.
- Injection of teflon paste in the vocal cord in cases of vocal cord palsy .
- Dilatation of subglottic stenosis.
How is direct laryngoscopy done? What is the procedure?
- This procedure is done under general anaesthesia. The patient is in Boyce position with flexion of the cervical spine and extension of the atlanto-occipital joint.
- The laryngoscope is held in the right hand and inserted into the oval cavity till the epiglottis is visualized. The tip of the epiglottis is lifted with the laryngoscope. The larynx is then visualized.
What are the possible complications of direct laryngoscopy?
Following are the possible complications of direct laryngoscopy:
- Damage to lips, gums, or tongue
- Damage to the cervical spine
- Anaesthetic complications
- Vasovagal stimulation due to manipulation of the larynx
However the above complications are greatly minimised in skilled hands and with good instrumentation setup.