喉镜和鼻咽镜

定义

Laryngoscopy is an exam of the back of your throat, including your voice box (larynx). Your voice box contains your vocal cords and allows you to speak.

选择的名字

Laryngopharyngoscopy; Indirect laryngoscopy; Flexible laryngoscopy; Mirror laryngoscopy; Direct laryngoscopy; Fiberoptic laryngoscopy; Laryngoscopy using strobe (laryngeal stroboscopy)

如何执行测试

Laryngoscopy may be done in different ways:

• Indirect laryngoscopy uses a small mirror held at the back of your throat. The health care provider shines a light on the mirror to view the throat area. 这是一个简单的程序. Most of the time, it can be done in the provider's office while you are awake. A medicine to numb the back of your throat may be used.
• Fiberoptic laryngoscopy (nasolaryngoscopy) uses a small flexible telescope. The scope is passed through your nose and into your throat. This is the most common way that the voice box is examined. 你在手术过程中醒着. Numbing medicine will be sprayed in your nose. This procedure typically takes less than 1 minute.
• Laryngoscopy using strobe light can also be done. Use of strobe light can give the provider more information about problems with your voice box.
• Direct laryngoscopy uses a tube called a laryngoscope. The instrument is placed in the back of your throat. 管子可能是柔性的，也可能是刚性的. This procedure allows the doctor to see deeper in the throat and to remove a foreign object or sample tissue for a biopsy. It is done in a hospital or medical center under general anesthesia, 也就是说你会睡着，不会感到疼痛.

如何准备考试

Preparation will depend on the type of laryngoscopy you will have. If the exam will be done under general anesthesia, you may be told not to drink or eat anything for several hours before the test.

考试的感觉如何

How the test will feel depends on which type of laryngoscopy is done.

Indirect laryngoscopy using a mirror or stroboscopy can cause gagging. For this reason, it is not often used in children under age 6 to 7 or those who gag easily.

Fiberoptic laryngoscopy can be done in children. It may cause a feeling of pressure and a feeling like you are going to sneeze.

为什么要进行测试

This test can help your provider diagnose many conditions involving the throat and voice box. Your provider may recommend this test if you have:

• 口臭不会消失
• Breathing problems, including noisy breathing (stridor)
• 长期(慢性)咳嗽
• 咳血
• 吞咽困难
• 耳朵的疼痛不会消失
• Feeling that something is stuck in your throat
• Long-term upper respiratory problem in a smoker
• Mass in the head or neck area with signs of cancer
• 喉咙痛不能消失
• Voice problems that last more than 3 weeks, 包括声音沙哑, 虚弱的声音, 刺耳的声音, 或者没有声音

A direct laryngoscopy may also be used to:

• Remove a sample of tissue in the throat for closer examination under a microscope (biopsy)
• Remove an object that is blocking the airway (for example, a swallowed a marble or coin)

正常的结果

A normal result means the throat, voice box, and vocal cords appear normal.

异常结果意味着什么

异常结果可能是由于:

• 反酸(GERD), which can cause redness and swelling of the vocal cords
• 癌症 喉咙或喉部的
• 声带上的结节
• 息肉 (良性肿块)在喉部
• 喉咙发炎
• Thinning of the muscle and tissue in the voice box (presbylaryngis)

风险

喉镜检查是一种安全的手术. 风险 depend on the specific procedure, but may include:

• Allergic reaction to anesthesia, including breathing and heart problems
• 感染
• 主要出血
• 鼻出血
• Spasm of the vocal cords, which causes breathing problems
• 口腔/喉咙粘膜溃疡
• 舌头或嘴唇受伤

注意事项

Indirect mirror laryngoscopy should NOT be done:

• 用于婴儿或非常年幼的儿童
• 如果你有急性会厌炎, an infection or swelling of the flap of tissue in front of the voice box
• 如果你不能把嘴张得很大

参考文献

Armstrong WB, Vokes DE, Tjoa T, Verma SP. 喉的恶性肿瘤. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7日艾德. Philadelphia, PA: Elsevier; 2021:chap 105.

Mark LJ, Hillel AT, Lester L, Akst SA, Cover R, Herzer K. General considerations of anesthesia and management of the difficult airway. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7日艾德. Philadelphia, PA: Elsevier; 2021:chap 5.

林志强，林志强，林志强. 睡眠呼吸暂停和睡眠障碍. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7日艾德. Philadelphia, PA: Elsevier; 2021:chap 15

塞德尔博士，梅斯纳，AH. Evaluation and management of the pediatric airway. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7日艾德. Philadelphia, PA: Elsevier; 2021:chap 206.

Syme NP, Hoffman HT, Anderson C, Pagedar NA,. 早期声门癌的处理. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7日艾德. Philadelphia, PA: Elsevier; 2021:chap 106.