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Considerations Before Starting Endoscopy

Criteria as to whether rigid or flexible endoscopy should be performed:

  • Pronounced gag response? Use flexible endoscopy.
  • What is the indication for laryngeal endoscopy examination:
    → Vocal fold mobility? Swallowing disorder? Subglottic or tracheal alterations? Use flexible endoscopy.
    → Tiny benign mass lesions? Rigid endoscopy might be considered.
  • General health condition and individual anatomy of patient (e.g. narrow nasal cavity, reduced jaw opening, the patient is lying flat)?
  • Is the patient able to cooperate?
  • What does the patient prefer?
  • Where possible it is often most helpful to use both techniques.

Setting Up The Patient:

  • Technique for administering local anesthetic.
  • Explain to the patient what you are about to do, what sensations are regularly encountered by patients and how the patient has to cooperate (how to breathe, how to sit, give a paper towel for saliva, use the tips that help limit an increased gag response)
  • When performing rigid endoscopy, instruct the patient to breathe through the mouth!
  • When performing flexible endoscopy, instruct the patient to breathe through the nose!


In the following chapters we show how endoscopists with a dominant right hand can perform the procedure. An endoscopist can of course perform the same procedure with their left hand.

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