About Your Diagnostic Laryngoscopy Under Anesthesia

This information will help you get ready for your diagnostic laryngoscopy at MSK including what to expect before and after your procedure.

A diagnostic laryngoscopy is a procedure that lets your surgeon look at your larynx (voice box) using an instrument called a laryngoscope. A laryngoscope is a tube with a camera at the end that your surgeon will use to get a clear view of your larynx. Your surgeon may also take a biopsy (sample of tissue) during the procedure.

Some people also have an esophagoscopy done at the same time. This is a procedure that looks at your esophagus (food pipe).

A laryngoscopy is usually done as an outpatient procedure in the operating room. You’ll get anesthesia (medicine that makes you sleep) during the procedure.

Before your procedure

Presurgical testing (PST)

You’ll have a PST appointment before your procedure. You’ll get a reminder from your healthcare provider’s office with the appointment date, time, and location. Visit www.msk.org/parking for parking information and directions to all MSK locations.

You can eat and take your usual medicines the day of your PST appointment.

It’s helpful to bring these things to your appointment:

• A list of all the medicines you’re taking, including prescription and over-the-counter medicines, patches, and creams.
• Results of any medical tests done outside of MSK in the past year, if you have them. Examples include results from a cardiac stress test, echocardiogram, or carotid doppler study.
• The names and telephone numbers of your healthcare providers.

You’ll meet with an advance practice provider (APP) during your PST appointment. They work closely with MSK’s anesthesiology (A-nes-THEE-zee-AH-loh-jee) staff. These are doctors with special training in using anesthesia during a procedure.

Your APP will review your medical and surgical history with you. You may have tests to plan your care, such as:

• An electrocardiogram (EKG) to check your heart rhythm.
• A chest X-ray.
• Blood tests.

Your APP may recommend you see other healthcare providers. They’ll also talk with you about which medicine(s) to take the morning of your procedure.

Since you will be asleep during your procedure, you must get ready for your laryngoscopy as if you were having surgery. Your nurse will give you the resource Getting Ready for Surgery. It has important information you will need to get ready for your procedure.

Ask about your medicines

You may need to stop taking some of your usual medicines before your procedure. Or, you may need to take a different dose (amount) than usual. Talk with your healthcare provider about how to take your medicines before your procedure. Do not change how you take your medicines without talking with a healthcare provider.

This section lists some examples of medicines, but there are many others. Make sure your care team knows all the prescription medicines, over-the-counter medicines, and dietary supplements you take. A prescription medicine is one you can only get with a prescription from a healthcare provider. An over-the-counter medicine is one you can buy without a prescription.

‌ It’s very important to take your medicines and supplements the right way in the days before your procedure. If you don’t, we may need to reschedule your procedure.
 

Anticoagulants (blood thinners)

If you take a blood thinner (medicine that affects the way your blood clots), ask the doctor doing your procedure what to do. Their contact information is listed at the end of this resource. Whether they recommend you stop taking the medicine depends on the reason you’re taking it.

Here are some examples of blood thinners. There are others, so be sure your care team knows all the medicines you take. Do not stop taking your blood thinner without talking with a member of your care team.

Read How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil. It has important information about medicines you’ll need to avoid before your procedure and what medicines you can take instead.

Diabetes medicines

If you take insulin or other diabetes medicines, talk with your MSK healthcare provider and the healthcare provider who prescribes it. Ask them what to do before your surgery or procedure. You may need to stop taking it or take a different dose (amount) than usual. You may also need to follow different eating and drinking instructions before your surgery or procedure. Follow your healthcare provider’s instructions.

Your care team will check your blood sugar levels during your surgery or procedure.

GLP-1 medicines for weight loss

It’s important to tell your healthcare provider if you take a GLP-1 medicine. You will need to follow special eating and drinking instructions before your surgery or procedure. It is very important to follow these instructions. If you do not follow them, your surgery or procedure may be delayed or canceled.

• Follow a clear liquid diet the day before your surgery or procedure. Do not eat any solid food. Read Clear Liquid Diet to learn more.
• Stop drinking 8 hours before your arrival time. Do not eat or drink anything after this time, including clear liquids. You can have small sips of water with your medicines.

To learn more, read Eating and Drinking Before Your Surgery or Procedure When Taking GLP-1 Medicines.

Here are some examples of GLP-1 medicines. There are others, so be sure your care team knows all the medicines you take. Sometimes, these are prescribed to help manage diabetes or other conditions. Other times, they are prescribed for weight loss.

Diuretics (water pills)

A diuretic is a medicine that helps control fluid buildup in your body. Diuretics are often prescribed to help treat hypertension (high blood pressure) or edema (swelling). They can also be prescribed to help treat certain heart or kidney problems.

If you take a diuretic, ask the healthcare provider doing your procedure what to do before your procedure. You may need to stop taking it the day of your procedure.

We’ve listed some examples of common diuretics below. There are others, so be sure your care team knows all the medicines you take.

Arrange for someone to take you home

You must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure.

If you don’t have a responsible care partner to take you home, call one of the agencies below. They’ll send someone to go home with you. There’s a charge for this service, and you’ll need to provide transportation. It’s OK to use a taxi or car service, but you still need a responsible care partner with you.

The day before your procedure

Note the time of your procedure

A staff member will call you after 2 p.m. the day before your procedure. If your procedure is scheduled for a Monday, they’ll call you on the Friday before. If you do not get a call by 7 p.m., call 212-639-5014.

The staff member will tell you what time to arrive for your procedure. They’ll also remind you where to go.

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

Instructions for eating

‌ Stop eating at midnight (12 a.m.) the night before your surgery or procedure. This includes hard candy and gum.

Your healthcare provider may have given you different instructions for when to stop eating. If so, follow their instructions. Some people need to fast (not eat) for longer before their surgery or procedure.

The day of your procedure

Instructions for drinking

Between midnight (12 a.m.) and 2 hours before your arrival time, only drink the liquids on the list below. Do not eat or drink anything else. Stop drinking 2 hours before your arrival time.

• Water.
• Clear apple juice, clear grape juice, or clear cranberry juice.
• Gatorade or Powerade.
• Black coffee or plain tea. It’s OK to add sugar. Do not add anything else.
  • Do not add any amount of any type of milk or creamer. This includes plant-based milks and creamers.
  • Do not add flavored syrup.

If you have diabetes, pay attention to the amount of sugar in your drinks. It will be easier to control your blood sugar levels if you include sugar-free, low-sugar, or no added sugar versions of these drinks.

It’s helpful to stay hydrated before surgeries and procedures, so drink if you are thirsty. Do not drink more than you need. You will get intravenous (IV) fluids during your surgery or procedure.

‌ Stop drinking 2 hours before your arrival time. This includes water.

Your healthcare provider may have given you different instructions for when to stop drinking. If so, follow their instructions.

Things to remember

• Take your medicines 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. People with the same or similar name may be having procedures on the same day.

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

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

You’ll get anesthesia through your IV. Once you’re asleep, your head will be tilted back. This gives your doctor the best view of your larynx and the areas around it.

Your doctor will insert a laryngoscope into your mouth and down your throat. It’s attached to a small video camera that can make your larynx look bigger, so the doctor can see it clearly. Your doctor may also use a special microscope to see better. If you need a biopsy of your larynx, your doctor will take them during the procedure as well.

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 they found during the procedure. If they took any biopsies, it will take up to a week to get the results. Your doctor will tell you when you can call to get this information.

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

At home

• If you had a biopsy taken, you may have a sore throat for a few days.
  • If you’re having any discomfort, you can rinse out your mouth and gargle with warm salt water. To make a salt water rinse, 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 help reduce any dryness or swelling in your throat.
• You may also cough up mucus that has some blood in it. This is normal and should stop within 7 days.
• If you usually take aspirin or products containing aspirin, you can start taking them again the day after your procedure after checking with your doctor first.
• You’ll have a follow-up appointment with your doctor in 5 to 7 days. At that time, your doctor will talk with you about the treatment option that’s best for you, based on your results.

When to contact your healthcare provider

Call your healthcare provider if you:

• Have a fever of 101 °F (38.3 °C) or higher.
• Have trouble breathing.
• Cough up bright red blood.