What to Know About Microlaryngoscopy

Microlaryngoscopy is a procedure that involves viewing the vocal cords with a microscope. Surgeons often use it to inspect for lesions like nodules, polyps, and cysts.

Microlaryngscopy is a minimally invasive surgery that allows surgeons to take a close-up look at the vocal cords and larynx (voice box) with a tiny microscope. They do this by placing a small tube into the mouth and down the throat.

If your doctor thinks you may have an issue with your vocal cords, they might recommend this procedure.

Here’s what you may want to know about microlaryngoscopy.

What is it?

While you’re under general anesthesia, a surgeon will insert a small tube through your mouth. They’ll pass the tube into your throat.

If this process helps the surgeon discover lesions or growths, they’ll remove them.

It’s also possible to surgically correct voice box or larynx-related conditions using this procedure. For instance, a surgeon can gently widen narrowed airways to help you breathe more easily.

Uses

Ear, nose, and throat surgeons (ENTs) typically perform microlaryngoscopy to assess for potential issues. Some conditions they may be looking for include:

• Noncancerous vocal cord lesions: Examples include nodules, polyps, and cysts.
• Laryngeal cancer: To diagnose this form of cancer, they’ll look for malignant (cancerous) lesions.
• Vocal fold paralysis: This is when nerve impulses to the larynx are interrupted , causing issues with speaking or breathing.
• Subglottic stenosis: This is a narrowing of the airways in the voice box, causing breathing or speech problems.
• Stridor: This is noisy breathing due to an obstruction or narrowed airway.

According to a 2017 paper , microlaryngoscopy has revolutionized the treatment of many conditions of the larynx that cause hoarseness. During treatment, the emphasis lies on preserving and protecting the throat and voice.

What to expect

Here’s what to expect before, during, and after the microlaryngoscopy procedure.

Before

If you have an upcoming microlaryngoscopy, speak with your surgeon for specific instructions in regard to your unique condition. But in general, before the procedure, you should :

• Let your surgeon know about any medications or supplements you’re taking.
• Fast for at least 8 hours before the procedure.
• Avoid smoking for at least one day before the procedure, but ideally longer.

In many cases, your surgeon will want you to stop smoking both before and after the procedure.

During

On the day of the procedure, you can expect:

• to go under general anesthesia, which will sedate you and prevent you from feeling any pain
• that the surgeon will insert a rigid tube through your mouth to assess your throat
• that they may use small surgical tools to remove growths or take biopsies from potentially cancerous lesions

After

The procedure should take less than an hour. Afterward, you can expect to:

• wake up in the recovery area feeling mildly sedated
• need someone to drive you home
• return home on the same day

How long does recovery take?

Microlaryngoscopy recovery is generally a simple and easy process. Always follow your surgeon’s specific instructions. But in general, you can expect to :

• have a sore or uncomfortable throat for a few days
• resume a typical diet within a day after the procedure
• return to your typical activities within a few days
• follow your surgeon’s orders about vocal rest, such as speaking less for a period ranging from days to weeks as your voice box heals

If your surgeon has advised you to be under vocal rest, you may need to temporarily limit:

• clearing your throat
• coughing
• singing
• talking
• whispering

Possible risks and complications

According to a 2022 review of suspension microlaryngoscopy, the procedure is safe and effective. It also has a low risk of complications and virtually no risk of mortality.

According to the review, the most common complications include:

• a temporary sore throat
• tongue issues, like numbness, taste issues, or pain
• temporary oral mucous issues
• very rarely, dental injuries and minor facial burns
• voice changes
• bleeding

General anesthesia may come with possible complications , such as:

• nausea
• grogginess
• a dry mouth
• muscle aches

Questions to ask your surgeon

Before undergoing microlaryngoscopy, you may want to ask your surgeon:

• How many of these procedures have you performed?
• What’s your personal complication rate?
• How long will I need to rest my voice after the procedure?
• When can I expect to see an improvement in my symptoms?
• What will my unique recovery look like?
• If this procedure doesn’t correct the issue, what are some alternatives?

The bottom line

Microlaryngoscopy is a valuable tool for diagnosing and treating a wide range of voice box and airway conditions. It involves assessing the throat with help from a small microscope attached to a tube. If necessary, a surgeon may remove lesions during this procedure.

Although it’s a surgical procedure, it’s generally safe and offers a quick recovery time for most people. Through microlaryngoscopy, many experience an immediate improvement in symptoms, such as easier breathing or an unobstructed voice.