CPT® Code 92614

1. Indications

The flexible endoscopic evaluation of laryngeal sensory function is indicated for various clinical scenarios where assessment of laryngeal sensitivity is necessary. This procedure is typically performed in the following situations:

• Assessment of Laryngeal Sensitivity This evaluation is crucial for patients presenting with symptoms such as hoarseness, dysphagia, or chronic cough, where laryngeal sensory function may be compromised.
• Evaluation of Airway Protection It is indicated for patients with a history of aspiration or those at risk for aspiration due to neurological conditions affecting swallowing and airway reflexes.
• Preoperative Assessment The procedure may be performed as part of a preoperative evaluation for patients undergoing surgeries that involve the larynx or surrounding structures.

2. Procedure

The flexible endoscopic evaluation of laryngeal sensory function involves several key procedural steps that ensure a thorough assessment of the larynx.

• Step 1: Patient Preparation The patient is positioned comfortably in a seated position to allow for optimal access to the throat. Local anesthesia is administered via an analgesic spray to numb the nasal passages and throat, which helps to minimize discomfort during the procedure.
• Step 2: Endoscope Insertion A flexible endoscope is carefully inserted through the patient's nose or mouth and advanced into the throat. The endoscope is equipped with a camera that allows for real-time visualization of the laryngeal structures.
• Step 3: Sensory Testing Once the endoscope is in place, puffs of air are delivered through the endoscope into the throat. This stimulation is designed to test the sensory function of the larynx, eliciting responses that can be visually assessed.
• Step 4: Recording and Documentation Throughout the procedure, cine or video images are recorded, capturing the laryngeal response to the air puffs. This visual documentation is critical for later analysis.
• Step 5: Review and Reporting After the procedure, the recorded images are reviewed in detail, and a comprehensive written report is generated, summarizing the findings related to laryngeal sensory function.

3. Post-Procedure

Post-procedure care for patients undergoing flexible endoscopic evaluation of laryngeal sensory function typically involves monitoring for any immediate adverse effects related to the procedure. Patients may experience temporary throat discomfort or a sensation of fullness, which usually resolves quickly. It is advisable for patients to avoid eating or drinking until the numbing effects of the analgesic spray have worn off to prevent aspiration. The written report generated from the procedure will provide essential information for further management or treatment plans based on the sensory function assessment.