ENT: Laryngoscopy
High-Yield Clinical Assessment for NEET PG
Laryngoscopy is the visualization of the larynx and pharynx. It is the gold standard for evaluating hoarseness, stridor, and suspected laryngeal malignancy.
1. Types of Laryngoscopy
| Type | Details |
|---|---|
| Indirect | Mirror laryngoscopy, classic, office-based, requires patient cooperation. |
| Fiberoptic (Flexible) | Gold standard for dynamic/functional assessment of patients with limited mouth opening. |
| Direct (Rigid) | Performed under GA; allows for biopsy, microlaryngeal surgery, and foreign body removal. |
2. NEET PG High-Yield Pearls
- Hoarseness (> 3 weeks): Absolute indication for laryngoscopy to rule out laryngeal carcinoma.
- Vocal Cord Nodules: Bilateral, symmetric lesions at the junction of the anterior 1/3 and posterior 2/3 of the vocal cords (“singer’s nodes”).
- Vocal Cord Polyps: Usually unilateral; often follow vocal abuse or trauma (e.g., vocal hemorrhage).
- Laryngomalacia: Most common cause of pediatric stridor. Characterized by omega-shaped epiglottis and redundant arytenoid mucosa collapsing inward during inspiration.
- Contraindications (Direct): Cervical spine instability (e.g., rheumatoid arthritis, trauma) is a critical relative contraindication due to the neck extension required.