If your doctor suspects you may have cancer of the larynx, he or she may want one or more of the following exams done:
- Physical exam.
The doctor will feel your neck and check your thyroid, larynx, and lymph nodes for abnormal lumps or swelling. To see your throat, the doctor may press down on your tongue.
- Indirect laryngoscopy.
The doctor looks down your throat using a small, long-handled mirror to check for abnormal areas and to see if your vocal cords move as they should. This test does not hurt. The doctor may spray a local anesthesia in your throat to keep you from gagging. This exam is done in the doctor's office.
- Direct laryngoscopy.
The doctor inserts a thin, lighted tube called a laryngoscope through your nose or mouth. As the tube goes down your throat, the doctor can look at areas that cannot be seen with a mirror. A local anesthetic eases discomfort and prevents gagging. You may also receive a mild sedative to help you relax. Sometimes the doctor uses general anesthesia to put a person to sleep. This exam may be done in a doctor's office, an outpatient clinic, or a hospital.
- CT scan.
An x-ray machine linked to a computer takes a series of detailed pictures of the neck area. You may receive an injection of a special dye so your larynx shows up clearly in the pictures. From the CT scan, the doctor may see tumors in your larynx or elsewhere in your neck.
This includes two procedures: Plain film x-rays and a modified barium swallow. The plain film x-rays are of the head, neck, and chest. They are done for a gross evaluation for tumor extent and/or metastasis. The modified barium swallow is most appropriate for dysphagia of attributable cause.
If an exam shows an abnormal area, the doctor may remove a small sample of tissue. Removing tissue to look for cancer cells is called a biopsy. For a biopsy, you receive local or general anesthesia, and the doctor removes tissue samples through a laryngoscope. A pathologist then looks at the tissue under a microscope to check for cancer cells. A biopsy is the only sure way to know if a tumor is cancerous.