Indirect laryngoscopy, generally done in a doctors office with a small mirror held at the back of the throat, allows the doctor to inspect the throat by using a head mirror and a light source that reflects light into the patient's mouth. This method has been largely replaced by use of a direct fiber-optic laryngoscopic technique that is more comfortable for the patient and provides better visualization. Fiber-optic laryngoscopy can also be used to evaluate the nasal passages. Most fiber-optic laryngoscopies are done by an ear, nose, and throat specialist (ENT) in the doctors office with the patient awake. A topical or local anesthetic may be used. The examination takes about 5 to 10 minutes.

Direct laryngoscopy is used for a deeper inspection of the throat and to perform surgical procedures. A flexible fiber-optic scope for examination provides better views and is better tolerated than older rigid scopes. Direct rigid laryngoscopy is often used to perform surgical procedures. The rigid laryngoscope may be used to remove foreign objects in the throat, biopsy tissue samples, remove polyps from the vocal cords, diagnose cancer of the voice box (larynx), or perform laser treatment. Direct rigid laryngoscopy is preferable to indirect laryngoscopy for children, patients with excessive gag reflexes, patients with laryngeal or pharyngeal disease, and those with a poor response to prior short-term therapy for laryngeal symptoms.

Direct rigid laryngoscopy is done in an operating room and requires a general anesthetic where the patient is deeply asleep and pain free. The procedure involves inserting the laryngoscope through the mouth and into the throat for direct visualization of the voice box (larynx). The examination usually takes 15 to 30 minutes. It may take several days for the doctor to receive results of biopsies taken for suspicious growths or tissues.

Patients are watched carefully for swallowing and breathing problems following this laryngoscopy. It is usually a very safe procedure with few complications. All types of laryngoscopy however do have a slight risk of triggering a life-threatening airway blockage. This risk is increased if there is a partially blocked airway from tumors, polyps, or severe swelling of the tissues at the back of the throat (epiglottitis). In the event of a complete airway blockage, it may be necessary for the doctor to make an incision in the neck called a tracheotomy to allow for breathing. This complication is very rare. Patients should consult their physician for a complete explanation of the procedure and its associated risks and complications.