Indications for performing a laryngoscopy in primary care settings primarily include persistent or unexplained symptoms suggestive of upper aerodigestive tract pathology, particularly when malignancy or significant structural abnormalities are suspected.
Specifically, laryngoscopy should be considered in patients presenting with persistent hoarseness lasting more than 3 weeks, unexplained throat or ear pain, dysphagia, or a persistent neck lump, as these may indicate laryngeal or hypopharyngeal cancer requiring urgent assessment and referral NICE NG36.
Additionally, laryngoscopy is indicated when there is suspicion of upper airway obstruction, stridor, or unexplained voice changes that do not resolve with initial treatment, to directly visualise the larynx and assess for lesions, inflammation, or anatomical abnormalities Moser 2014.
In primary care, the procedure is also useful for evaluating chronic cough or globus sensation when other causes have been excluded, aiding in diagnosis and guiding further management NICE NG36; Moser 2014.
Overall, the decision to perform laryngoscopy in primary care should be guided by clinical suspicion of serious pathology, failure to respond to initial treatment, and the need for direct visual assessment to expedite diagnosis and referral NICE NG36; Moser 2014.