Diagnostic Laryngoscopy With or Without Esophagoscopy Under Anesthesia

This information will help you prepare for your diagnostic laryngoscopy at Memorial Sloan Kettering Cancer Center (MSK).

A diagnostic laryngoscopy is a procedure that allows your surgeon to examine your larynx (voice box) using an instrument called a laryngoscope. A laryngoscope is a tube with a camera at the end that your surgeon uses to get a clear view of your larynx. Some patients also have an esophagoscopy done at the same time. This is an examination of the esophagus (food pipe). Your surgeon may also take a biopsy (sample of tissue) of the lesion(s) during the procedure.

A laryngoscopy is usually done as an outpatient procedure in the operating room. You will be asleep during the procedure.

Before Your Procedure

Presurgical Testing

Before your procedure, you will be given an appointment for presurgical testing (PST). During your PST appointment, you will meet with a nurse practitioner who works closely with anesthesiology staff (doctors and specialized nurses who give you medication to sleep during surgery). You can eat and take your usual medications the day of your PST appointment.

During your appointment, your nurse practitioner will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests necessary to plan your care. Your nurse practitioner may also recommend you see other healthcare providers.

It is very helpful if you bring the following with you to your PST appointment:

  • A list of all the medications you’re taking, including patches and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram (echo), or carotid doppler study.
  • The name(s) and telephone number(s) of your doctor(s).

Since you will be asleep during your procedure, you must prepare for your laryngoscopy as if you were having surgery. Your nurse will give you a resource called Getting Ready for Surgery. It contains important information you will need to prepare for your procedure.

Review your medications

Be sure your nurse practitioner and your doctor know all of the medications you’re taking. If you take medication to thin your blood, such as to treat blood clots or to prevent a heart attack or stroke, ask your doctor if you should stop taking it. Some examples are aspirin, warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and cilostazol (Pletal®). Do not stop taking these medications without talking with your doctor.

Some medications, such as aspirin, ibuprofen (Advil®, Motrin®), and vitamin E, can cause bleeding problems. Do not take medication that has them unless your doctor says it is ok.

  • Stop taking vitamin E 10 days before your procedure, or as instructed by your doctor.
  • Stop taking aspirin 7 days before your procedure, or as instructed by your doctor.
  • Stop taking ibuprofen and other nonsteroidal anti-inflammatory medications (NSAIDs) 2 days before your procedure.

Arrange for someone to take you home

If you will be leaving the hospital after your procedure, you must have a responsible adult take you home when you’re discharged from the recovery area. If you don’t have someone who can do this, please call one of the agencies below. They will help find someone to take you home.

  • Partners in Care        888-735-8913
  • Caring People           877-227-4649
  • Prime Care                212-944-0244
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The Day Before Your Procedure

Note the time of your procedure

A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. He or she will tell you what time you should arrive at the hospital for your procedure. If you are scheduled for your procedure on a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 pm, please call 212-639-5014

If you need to cancel your procedure for any reason, please call the doctor who scheduled it for you.

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The Day of Your Procedure

Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of clear liquids (see Figure 1). 

Figure 1. 12 ounces of clear liquid

Examples of clear liquids include:

  • Clear broth, bouillon, or consommé (no particles of dried food or seasonings) 
  • Gelatin, such as Jell-O® 
  • Clear fruit juices (no pulp), such as white cranberry, white grape, or apple 
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, or Gatorade® 
  • Coffee or tea, without milk or cream 

Things to remember

  • Take your medications the morning of your procedure as instructed by your doctor. Take them with a few sips of water.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar name may be having procedures on the same day.

After changing into a hospital gown, you will meet your nurse. He or she will place an intravenous (IV) catheter into a vein, usually in your hand or arm. At first, you will receive fluids through the IV, but it will be used later to give you anesthesia (medication to make you sleep during your procedure).

When it’s time for your procedure, you will be brought into the procedure room and helped onto an exam table. You will be attached to equipment to monitor your heart, breathing, and blood pressure.

You will receive anesthesia through your IV. Once you are asleep, your head will be tilted back. This gives your surgeon the best view of your larynx and the areas around it. Your surgeon will insert a laryngoscope into your mouth and down your throat. It is attached to a small video camera that can enlarge the view. Your surgeon may also use a special microscope to see the lesion(s) better. If any biopsies of your lung tissue are needed, your surgeon will take them during the procedure as well.

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After Your Procedure

In the hospital

You will wake up in the Post-Anesthesia Care Unit (PACU). Your nurse will continue to monitor your heart, breathing, and blood pressure. Your doctor will talk with you about what he or she saw. If biopsies were taken, it will take 4 to 5 days to get the results. Your doctor will tell you when to call for this information.

Once you are fully awake and alert, you can go home.

At home

  • You may have a sore throat for several days if a biopsy was taken.
    • You can rinse your mouth and throat with warm salt water to help with any discomfort. Dissolve 1 tablespoon of salt in 1 quart of warm water. Gargle as often as you like.
    • You may want to use a humidifier to reduce the dryness in your throat and help reduce swelling.
  • You may also cough up blood-tinged mucus. This is normal and should go away within 7 days.
  • If you usually take aspirin or products containing aspirin, you can start taking them again the day after your procedure.
  • You will have a follow-up appointment with your doctor in 5 to 7 days. At that time, your doctor will talk with you in detail about the treatment option that is best for you.
  • Have a temperature of 101º F (38.3º C) or higher
  • Have shortness of breath or difficulty breathing
  • Cough up bright red blood
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