Introduction to indirect laryngoscopy

Seeing a doctor can sometimes be quite embarrassing. For example, a female doctor may be treating a male disease, or a male doctor may be examining a woman's breasts and private parts. Although the doctors are used to it, I still mind it. Every time I think, it would be great if there were machines to replace this kind of inspection. Here we introduce the indirect laryngoscopy method for your reference.

Indirect laryngoscopy

1. The patient sits with his head and shoulders slightly tilted forward, facing the light, and warms the laryngoscope over an alcohol lamp. The examiner uses the back of his hand to test whether it is too hot.

2. Ask the patient to open his mouth and stick out his tongue. Wrap the tip of the tongue with sterile gauze and gently pull out the tongue.

3. Hold the laryngoscope in your right hand and insert it through the left corner of the patient's mouth so that the mirror is parallel to the back of the tongue. When it reaches the soft palate and uvula, it will form a 45° angle with the ground, and you can see the root of the tongue, epiglottis, epiglottic crevasses, and pyriform sinuses.

4. Ask the patient to make an "Eey...Eey" sound. When the epiglottis is erected, the arytenoid process, ventricular cords, vocal cords and glottis can be seen. The glottis is closed during pronunciation. Ask the patient to breathe quietly. When the vocal cords are abducted, observe whether the vocal cord movement is normal. The subglottic area and part of the tracheal rings can be seen through the glottis. Pay attention to whether there is congestion, deformity, foreign matter, swelling, ulcer, hypertrophy, tumor, mucosal color and secretions, etc. If the patient's pharyngeal reflex is too strong, spray the pharynx with tetracaine solution 2 to 3 times and then check.

5. If the epiglottis cannot be lifted and the glottis cannot be fully seen, the epiglottis can be hooked forward with a throat cotton ball for examination under surface anesthesia, or a fiberoptic laryngoscopy can be performed.

Indirect laryngoscopy precautions

(1) All parts of the throat, including the back, front, left, right, top and bottom, should be checked in sequence as a routine procedure to avoid omissions. Pay attention to the presence of congestion, swelling, hyperplasia, or ulcers. If there is vocal cord movement disorder, pay attention to the presence of tumors, cricoarytenoid joint disease, or vocal cord paralysis in the laryngeal ventricle or subglottic area. Salivary retention in the pyriform sinus may be caused by a retrocranial tumor, an upper esophageal tumor, a foreign body, or paralysis of the pharyngeal muscles. Superficial ulcers or granulation tissues between the arytenoids are common in patients with laryngeal tuberculosis.

(2) Examination of patients with a thick and short tongue, a short frenulum, an overly long epiglottis, or an infantile tongue is often difficult; examination of young children is also often difficult to succeed; lesions at the anterior laryngeal commissure are particularly easy to be overlooked. All patients who cannot be clearly identified under indirect laryngoscopy should undergo direct laryngoscopy.

(3) The image seen in the indirect laryngoscopy is an inverted image of the larynx, that is, the front part shown in the laryngoscopy is actually the back part of the larynx, but the left and right are not reversed.

(4) The image in the laryngoscope is elliptical, and the vocal cords, glottis and other tissues shown are 2/3 of their actual length. The color of the laryngeal mucosa is related to the intensity of the incident light. Strong light often makes the congested mucosa look normal or lighter in color.

The above is an introduction to indirect laryngoscopy. I hope it will be helpful to you. The throat is very important to the human body. People often say the throat is a key place, which also illustrates this problem. Therefore, it is very important to diagnose throat diseases, and indirect laryngoscopy makes it much more convenient. I believe that with the advancement of science and technology, medicine will develop faster and the examination methods will be more convenient and advanced.