Laryngoscopy (larynx + scopy) is a medical procedure that is used to obtain a view of the vocal folds and the glottis.Laryngoscopy may be performed to facilitate tracheal intubation during general anesthesia or cardiopulmonary resuscitation or for procedures on the larynx or other parts of the upper tracheobronchial tree.

Direct laryngoscopy
Direct laryngoscopy is carried out (usually) with the patient lying on his or her back; the laryngoscope is inserted into the mouth on the right side and flipped to the left to trap and move the tongue out of the line of sight,and,depending on the type of blade used,inserted either anterior or posterior to the epiglottis and then lifted with an upwards and forward motion ("away from you and towards the roof ").This move makes a view of the glottis possible.This procedure is done in an operation theatre with full preparation for resuscitative measures to deal with respiratory distress.There are at least ten different types of laryngoscope used for this procedure,each of which has a specialized use for the otolaryngologist and medical speech pathologist.This procedure is most often employed in direct diagnostic laryngoscopy with biopsy.It is extremely uncomfortable and is not typically performed on conscious patients,or on patients with an intact gag reflex.

Indirect laryngoscopy
Indirect laryngoscopy is performed whenever the provider visualizes the patient's vocal cords by a means other than obtaining a direct line of sight.For the purpose of intubation,this is facilitated by fiberoptic bronchoscopes,video laryngoscopes,fiberoptic stylets and mirror or prism optically-enhanced laryngoscopes.



Conventional laryngoscope
The vast majority of tracheal intubations involve the use of a viewing instrument of one type or another.Since its introduction by Kirstein in 1895,the conventional laryngoscope has been the most popular device used for this purpose.Today,the conventional laryngoscope consists of a handle containing batteries with a light source,and a set of interchangeable blades.

Conventional laryngoscope
The vast majority of tracheal intubations involve the use of a viewing instrument of one type or another.Since its introduction by Kirstein in 1895,the conventional laryngoscope has been the most popular device used for this purpose.Today,the conventional laryngoscope consists of a handle containing batteries with a light source,and a set of interchangeable blades.

Fiberoptic laryngoscopes
Besides the conventional laryngoscopes,many other devices have been developed as alternatives to direct laryngoscopy.These include a number of indirect fiberoptic viewing laryngoscopes such as the flexible fiberoptic bronchoscope.The flexible fiberoptic bronchoscope or rhinoscope can be used for office-based diagnostics or for tracheal intubation.The patient can remain conscious during the procedure,so that the vocal folds can be observed during phonation.Surgical instruments passed through the scope can be used for performing procedures such as biopsies of suspicious masses.These instruments have become indispensable within the otolaryngology,pulmonology and anesthesia communities.

Other available fiberoptic devices include the Bullard scope,UpsherScope,and the WuScope.These devices are widely employed for tracheal intubation,especially in the setting of the difficult intubation (see below).

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