• • Diagnostic:
  • When indirect laryngoscopy is not possible, e.g. in young children and infants for laryngeal lesions like stridor.
  • Vocal cord paralysis.
  • Extent of the growth in cases of carcinoma of the vocal cords and to take a biopsy.
  • As a part of panendoscopy in cases of unknown primary with cervical metastasis.
  Therapeutic:
  • Excision of benign lesions of the larynx such as papilloma, vocal nodules or cyst.
  • Insertion of laryngeal stents.
  • Injection of teflon paste in the vocal cord in cases of vocal cord palsy.
  • Dilatation of subglottic stenosis.

  Procedure:

  • Procedure is done under general anesthesia.
  • The patient is in Boyce position with flexion of the cervical spine and extension of the atlanto-occipital joint.
  • The laryngoscope is held in the right hand and inserted into the oval cavity till the epiglottis is visualized.

• 4. The tip of the epiglottis is lifted with the laryngoscope.
• 5. The larynx is then visualized.

Structure visualized:

Following structures are examined serially:
• Base of tongue.
• Median and lateral glossoepiglottic fold.
• Right and left valleculae.
• Epiglottis (its tip, lingual and laryngeal surfaces).
• Right and left pyriform sinuses.
• Aryepiglottic folds.
• Arytenoids.
• Postcricoid region.
• Both false cords.
• Anterior and posterior commissure.
• Right and left ventricles.
• Right and left vocal cords.
• Subglottic area.
• Mobility of vocal cords is also observed.