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LaryngoscopyLaryngoscopy is a technique that allows to observe the interior of the pharynx and the upper part of the larynx. This test allows us to study the interior of the upper airway, and also allows other procedures more invasive, as biopsies, surgeries little invasive and intubation of the airway in people unconscious or anesthetized. The specialist that used this technique is the Otolaryngologist, though also used by anaesthetists and the intensivists.
The pharynx has three parts: the nasopharynx (just behind the nose), Oropharynx (in the background of the mouth), and the hypopharynx (which connects to the esophagus and the airway). Laryngoscope, which is called the unit that held the laryngoscopy, allows to observe the three parts and the upper part of the larynx, where in addition the vocal cords will be.
Since there is this technique have been developed different laryngoscopes, that are used today are:
Indirect laryngoscope: is a rigid bar that is inserted through the mouth until the end of the language. In the end you have a mirror which reflects the upper part of the larynx and hypopharynx. Only allows the display, other procedures are not performed with him.
Rigid direct laryngoscope: consists of a small rigid joystick that is inserted through the mouth and move the tongue forward, in such a way that the larynx can be seen directly at a glance. It is a technique that requires that the person is unconscious or anesthetized, since it would be extremely upset if not. It is the instrument that most Anesthetists and the medical intensivists, used since it allows them to intubate the Airways.
Flexible direct laryngoscope or fibrolaringosopio: is the most widely used routinely in conscious people. It is a small flexible tube containing optical fibers with a camera on the end. It is inserted through the nose and pharynx up to lower part flows through.
When a laryngoscopy is madeLaryngoscopy is a useful technique in the following situations or health problems:
Study of chronic throat pain: laryngoscopy serves to identify lesions which can cause sore throat for more than three weeks and does not respond to standard medical treatment.
Alterations of voice: can diagnose diseases of vocal cords. Before for this purpose, you must wait three weeks because in many cases are transitory laryngitis that do not require study.
Chronic cough: when a person begins to cough for more than three weeks or habitual cough changes shape, should be studied to verify that no alterations in the upper airway.
Suspicion of cancer: laryngoscopy can observe if there are tumors of the Airways above, very frequent in smokers.
Choking: confirms the blocking of the airway by foreign elements. Sometimes it allows you to reach them and pull them.
Difficulty swallowing: this test allows to discard physical injuries that hamper the action of swallowing. You can see live the movement of the pharyngeal muscles.
Taken from biopsies: suspicious masses of cancer, polyps of vocal cords or chronic ulcers, you can take samples with a small pair of tweezers or needle.
The airway intubation: anaesthetists and intensivists doctors used the laryngoscope in people unconscious to observe the upper airway and to introduce a hollow tube that allows to ventilate the patient and keep your breathing artificially.
How laryngoscopyFirst, the doctor will assess if it may be useful to perform the laryngoscopy. If so one day one will quote you to carry it out or you will be at that time. The day of the test must carry out a normal life, and you can eat or drink just before the procedure. When you arrive at the clinic they ask you that you sit in a Chair and relax.
When you are comfortable you will introduce you a thin, flexible tube through one of the nostrils. When ask you that you finish as if you were drinking a drink of water. You will notice a strange feeling, as if you had some food into the throat. Despite this does not tend to feel strong nausea and it is very rare that des arcades. The best is to be relaxed and keep a regular and rhythmic breathing.
Once inside the Otolaryngologist will see inside the walls of the pharynx. It will look for alterations or malformations. Then be set at the top of the larynx made the same observations, and will focus on the vocal cords. Maybe calling you that you speak, you make a high-pitched sound and some serious. Thus the vocal cords move and you can see if there is any paralysis or injury (polyps, ulcers, edema...).
It will then leave the fibrolaringoscopio without stopping in more observations. If it is necessary to perform some procedure, the doctor will decide if hacelro at the same time or quote you for another day. It depends on the urgency of the same and if necessary suspend any medication before.
In the case of the direct laringoscopias, you'll be anesthetized or unconscious, so it does not you will notice nothing. When you recover the knowledge it is frequent that notes any discomfort in the throat or any alteration in the voice. The culprit is usually the laryngoscopy itself, but of the airway intubation.
Complicaciones de la laringoscopiaLa laringoscopia no suele tener complicaciones. Sin embargo, alguno de los problemas que pueden aparecer son:
- Nauseas con o sin vómitos.
- Heridas con sangrado de la lengua, nariz, faringe o laringe.
- Transmisión de infecciones, sobre todo si ha habido una herida antes.
- Espasmo de las cuerdas vocales, que pueden cerrarse cuando se manipula esa región de la vía aérea.
- Complicaciones típicas de la anestesia (alergia, arritmias, etcétera) cuando se utiliza para intubar.
Preparación para la laringoscopiaPara explicar la preparación de la laringoscopia vamos a centrarnos en la laringoscopia directa flexible o fibrolaringoscopia, ya que es el procedimiento más habitual en una consulta. La laringoscopia directa rígida se utiliza en situaciones de emergencia (sin preparación previa) o al realizar la anestesia de una cirugía (por lo que la preparación para esta prueba sería la de cualquier cirugía).
Si te van a realizar una fibrolaringoscopia estas son las cuestiones que debes tener en cuenta para ir bien preparado a la prueba:
Duración: la prueba dura muy poco tiempo. Pueden ser suficientes menos de cinco minutos. En el caso de realizarte algún procedimiento (biopsias, aspirados, extracciones de elementos extraños, etcétera) la duración puede ser mayor, pero normalmente no superará la media hora, porque más tiempo sería molesto.
Income: the fibrolaringoscopia can be done in a clinic or in a hospital. Income is not necessary.
Is necessary to be accompanied?: do not need to be accompanied. It is a little annoying and low risk test. Although if they are going to perform some procedure it may be good idea to have someone accompany you to go more quiet.
Drugs: don't need to take any prior medication. You should tell your doctor all the medicines taken regularly and will decide which suspend or maintain, especially if you take antiplatelet drugs (aspirin, ibuprofen...) or anticoagulants (acenocoumarol, dabigatran) that may hinder the taking of biopsies.
Food: it is not necessary to remain in fasting hours before the test or after. Nausea that causes the fibrolaringoscopia they are minimal, but it is prudent to not have eaten just before the test case. In the case of the laringoscopias rigid if it is necessary to stay in fasting, as requested before a surgery.
Clothes: you can go to the quote from the test with the same clothes every day.
Documents: is essential to bring with you the steering wheel which shows the performance of this test. The health insurance card is recommended. After the laryngoscopy deliver you a report, but if they have collected samples they will take a time to analyse them.
Pregnancy and lactation: this technique is not contraindicated in pregnancy or lactation.
Contraindications: laryngoscopy does not have any specific contraindication. In people with anatomical disorders of the nose or pharynx may be difficult to perform this test.
Results of the laringosocopiaDuring laryngoscopy doctor can go looking at injuries and disorders of the upper airway. At the same time you can perform Diagnostics with enough safety, since there are very typical alterations that are identified with the naked eye. At other times you will need to perform any test sample (biopsy, crops...) to confirm the diagnosis.
All the results of the laryngoscopy will write them in a report that you can make at the end of the consultation and surrender in hand, or if it is extensive may prefer to write it calmly and send it to you or the doctor who has asked you to test. When there is outstanding evidence it will wait for results to give a definitive diagnosis. In this report you can also include photos that you have made during the test, something very useful when it is necessary to track if you change known lesions.
When you pick up the report, the doctor will explain the alterations that have been throughout the study. Following the results, it will propose more testing if he deems it necessary or will provide possible solutions to the problem you have, whether medical or surgical interventions.