Examination Under Anesthesia or Suspension Laryngoscopy
Diagnostic or therapeutic procedures are usually performed whenever indicated. The former include those patients found to have definite lesion such as mass or growth which need a biopsy for confirmatory diagnosis. Other reasons include for proper microscopic evaluation of hidden vocal fold obscured by the epiglottis and intolerance to office examination especially amongs children.
Intraoperative assessment of larynx under general anaesthesia showing a sessile right vocal polyp (arrow) which was earlier thought to be a cyst based on an outpatient laryngeal endoscopy. Microsurgical removal was then performed and the specimen sent for histopathological assessment. (LVF - left vocal fold, RVF -right vocal fold, ETT - endotracheal tube)
Therapeutic procedures are usually performed to correct and cure the abnormalities found on endoscopic evaluation e.g., vocal fold cyst, polyp, vocal process granuloma, early tumour growth or mass, and vocal fold palsy. These aims at improving the patient’s voice, alleviate laryngeal obstruction, or improving swallowing by minimizing risk of aspiration.
In many cases, it serves both functions and offers tremendous benefit for the patient.
Laryngeal image taken during endoscopic assessment under general anaesthesia prior to definitive surgery in a patient presented with hoarseness. [Arrow - anterior commissure scar, rounded rectangle - vascular ectasia, RVF - right vocal fold, LVF - left vocal fold]