There are two major types of flexible laryngoscopes:

Types of anatomy and function seen with the flexible scope not available with rigid scope:

  • palate closure
  • panoramic functional view of pharynx
  • swallowing evaluation
  • detailed view of anterior commissure even when epiglottis is overhanging
  • detailed view of anterior larynx when larynx is topically anesthetized and the flexible scope is placed in the posterior larynx and angled directly anteriorly
  • laryngeal ventricles
  • subglottic view
  • tracheal view
  • mainstem bronchi view
  • transtracheal view of subglottis when tracheostome present

When choosing a flexible endoscope there are a number of considerations.

  • Diameter of scope
  • Curvature of tip
  • Distance of curvature from tip

These considerations affect how easy it is to pass the endoscope through the nose. Endoscopes larger than 4 mm in diameter can be difficult to fit in a fair number of individuals or require a lot of decongestion and topical anesthesia to get them through. This takes added time for the examination. A smaller radius of curvature at the tip and a radius that is nearer the tip allows more freedom of movement in the narrow confines of the pharynx and larynx.

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Fiberoptic scope tip flexibility and distance from tip matter when maneuvering within the larynx. Upper endoscope: long tip and uneven articulation. Lower endoscope: even radius curve near the tip allows close insertion into the larynx parallel to the true vocal cords

Larger endoscopes transmit more light. They allow for a working channel to be present.