How to do laryngoscopy? These examinations are essential

Having a healthy body is everyone's common wish, but the arrival of disease is often silent. With the development of society, the incidence of laryngeal cancer continues to increase. In response to patients' questions about how to diagnose laryngeal cancer, we have specially invited well-known experts to talk to you. The following is detailed knowledge about laryngeal cancer diagnosis.

Laryngoscopy is a visual examination of the back of the larynx down to where the voice box (larynx) including the vocal cords is located. It is an effective method to detect causes of voice and breathing problems, throat or ear pain, difficulty swallowing, pharyngeal stenosis (narrowing or narrowing) and airway obstruction.

Laryngoscopy is relatively painless, but the idea of ​​inserting a scope down the throat can be a little scary for children, so it helps to understand how laryngoscopy is done.

Laryngoscopy is done by an ear, nose, and throat specialist (ENT). The three types of laryngoscopes are:

Indirect laryngoscope

Fiber optic (flexible) laryngoscope

Direct laryngoscopy

The indirect procedure can be done in the doctor's office by holding a small hand mirror behind the throat. The doctor points a light down the back of the throat, usually while wearing a headgear with a bright light, to examine the larynx and vocal cords. Indirect laryngoscopy is not usually used in children because it tends to cause bad breath.

With fiberoptic and direct laryngoscopy, doctors can use flexible or rigid telescopes to view deeper into the throat. Rigid telescopes are used more often as part of surgical procedures to evaluate children for rhabdomyosarcoma (noisy, harsh breathing) and to remove foreign objects in the throat and lower airway. They are also used to collect tissue samples (biopsy), for laser treatment, and to locate laryngeal cancer.

Why do I need a laryngoscopy?

The goals of laryngoscopy are to:

Diagnose persistent cough, sore throat, bleeding, hoarseness, or persistent bad breath.

Check for inflammation

Finding possible narrowing or obstruction in the throat

Removal of foreign matter

To observe or biopsy a mass or tumor in the larynx or vocal cords

Diagnosing dysphagia

Diagnosing suspected cancer

Evaluating the cause of persistent ear pain

Diagnose voice problems such as weak voice, hoarse voice, breathy sounds, or no voice.

Laryngeal cancer is also classified, mainly into primary and secondary. The main symptoms of this cancer are difficulty in swallowing, coughing, hoarseness, etc. If you have such symptoms, you should go to the hospital for examination and diagnosis in time. So how to differentiate laryngeal cancer? Today we will talk about the examination items for laryngeal cancer.

1. Neck examination

This includes inspection and palpation of the laryngeal shape and cervical lymph nodes. Observe whether the larynx is enlarged and palpate the cervical lymph nodes. The cervical lymph nodes should be inspected step by step from top to bottom and from front to back according to the distribution pattern of the cervical lymph nodes to find out the location and size of the enlarged lymph nodes.

2. Laryngoscopy

(1) Indirect laryngoscopy is the simplest and most convenient method and can be performed in an outpatient clinic. During the examination, it is necessary to see all parts of the larynx clearly. Due to the patient's cooperation, sometimes it is not possible to clearly examine the various structures of the larynx, and further other examinations such as fiberoptic laryngoscopy are needed.

(2) Direct laryngoscopy can be used for patients who have difficulty in obtaining a biopsy under indirect laryngoscopy, but it is very painful for the patient.

(3) Fiberoptic laryngoscope examination: The fiberoptic laryngoscope is slender, soft, bendable, bright, has a certain magnification function, and has the function of taking biopsies. It is helpful to see the whole picture of the laryngeal cavity and adjacent structures, and is conducive to early detection of tumors and biopsies.

(4) Stroboscopic laryngoscopy can detect tumors at an early stage by dynamically observing the vibration of the vocal cords.

3. Imaging examination

X-rays, CT scans, and MRIs can be used to determine the extent to which laryngeal cancer has invaded surrounding tissues and organs and the extent to which it has metastasized. Superficial ultrasound imaging can be used to observe metastatic lymph nodes and their relationship with surrounding tissues.

4. Biopsy

Biopsy is the main basis for the diagnosis of laryngeal cancer. The specimen can be collected under laryngoscope. Note that the central part of the tumor should be taken with forceps, not on the ulcer surface, because there is necrotic tissue there. Some cases require repeated biopsies to confirm. The biopsy should not be too large or too deep to avoid bleeding.

A detailed medical history and physical examination of the head and neck, indirect laryngoscopy, laryngeal X-ray, laryngeal CT, MRI examination, etc. can determine the location, size and extent of laryngeal cancer tumor lesions.