Getting Ready for Direct Laryngoscopy

How is the surgery done?

• The surgery is done under general anesthesia (completely asleep).
• A scope is passed through your mouth to look closely at all parts of your throat and voice box. If there are areas of concern, biopsies may be taken.
• Sometimes a longer scope is used to look down the esophagus (food pipe). This is called esophagoscopy.
• If you have a growth on a vocal cord, a microscope is used to look at the vocal cords closely and the growth is carefully removed.

What are the risks?

Every surgery has risks. Your surgeon will go over them with you before surgery, and you can ask about any of them.

• Anesthesia is safe, but it has some risks. The anesthesia team can go over them with you. Tell us if anyone in your family has had a problem with anesthesia.
• Pain, bleeding and infection are risks of any surgery.
• Injury to the lips, teeth, tongue or gums can happen. Your tongue may be temporarily numb after surgery.
• Voice changes or trouble swallowing, usually temporary.
• Biopsies may not be enough to make a diagnosis, and more procedures may be needed.
• If esophagoscopy is done: a tear in the esophagus, which could lead to a severe, possibly life-threatening chest infection.
• If a vocal cord growth is removed: scarring of the vocal cord, which could cause lasting or worse voice problems, and the growth coming back, which could need more surgery.

How do I get ready?

• As soon as surgery is scheduled

  • Give us a list of every medicine, vitamin and supplement you take. We will tell you which to stop and when.
  • If you smoke or vape, stop now. Stopping helps your body heal and makes anesthesia safer, and the earlier you stop, the better: aim for at least 4 weeks before surgery, though even 2 weeks helps. Stay off until your surgeon says you have healed.
  • Plan time off. Most people take 24 to 48 hours off work or school.
  • Arrange for an adult to drive you home. After general anesthesia, we recommend having an adult stay with you the first night.

• 1 to 2 weeks before

  • Aspirin is usually stopped 1 to 2 weeks before surgery. If you take aspirin or a blood thinner for your heart, a stent or stroke prevention, do not stop it on your own: your surgeon will check with whoever prescribes it.
  • Ask us whether to pause ibuprofen (Advil, Motrin) or naproxen (Aleve).
  • Ask about herbal remedies and supplements, such as fish oil, vitamin E, ginkgo or garlic pills, which can raise the chance of bleeding.
  • If you take insulin or other diabetes medicines, ask how to take them before surgery.
  • If a vocal cord growth is being removed, plan for strict voice rest (no talking) for at least 3 days afterward. Tell the people you live and work with.
  • Get the supplies in the next section.

• The night before

  • Follow the eating and drinking instructions from our office or the surgery center exactly. If you eat or drink when you should not, surgery may need to be postponed for safety.
  • Many places ask for nothing to eat after midnight, and some allow clear liquids until a few hours before.
  • Take only the medicines we said to take that morning, with a small sip of water.
  • Get a good night’s sleep.

• The day of surgery

  • Wear comfortable clothes.
  • Wear glasses instead of contact lenses, and leave jewelry and valuables at home.
  • Bring your photo ID, insurance card and list of medicines.

What happens after surgery?

• Most people go home the same day and take 24 to 48 hours off work or school.
• Eat soft foods for several days, until swallowing is comfortable.
• If a vocal cord growth was removed: strict voice rest for at least 3 days, sometimes longer. Your surgeon will tell you how long.
• Your follow-up visit is about 1 week after surgery. If biopsies were taken, we review the results then.

The Direct Laryngoscopy Recovery Guide has everything you need after the procedure, including when to call us.

When should I call before surgery?