An upper endoscopy, technically known as an esophagogastroduodenoscopy (EGD), utilizes a thin, flexible tube equipped with a light and camera to examine the upper digestive tract. This examination covers the esophagus, stomach, and the first part of the small intestine. While a temporary sore throat and voice changes are common following the procedure, the concern regarding serious, permanent damage to the vocal cords is not generally supported by the procedure’s low complication rate. Vocal cord irritation is a frequent, short-lived side effect.
Differentiating Endoscopic Procedures
The term “endoscopy” describes any procedure where a scope is inserted into the body to view internal structures. The risk to the vocal cords is specifically tied to procedures that navigate through or immediately adjacent to the larynx, or voice box. An Upper GI Endoscopy (EGD) involves passing the scope through the throat and past the pharynx and upper esophageal sphincter. Other procedures, such as a Bronchoscopy, guide the scope into the airways to examine the lungs, meaning the tube passes directly between the vocal cords. Similarly, a Laryngoscopy is an examination focused entirely on visualizing the larynx and the vocal cords themselves. Since the EGD passes the tube through the throat to reach the esophagus, it is the most common gastrointestinal procedure associated with direct contact risk to the surrounding structures.
How Vocal Cord Trauma Occurs
Vocal cord trauma during an EGD can arise from two primary mechanical pathways: direct frictional contact and trauma associated with general anesthesia. The most frequent cause of irritation is the physical passage of the endoscope as it maneuvers through the pharynx and upper esophageal opening. This insertion can cause mild mucosal abrasion or bruising to the surrounding tissue, leading to a temporary feeling of scratchiness and vocal fatigue.
A more significant, though rare, risk is related to the use of deep general anesthesia, which may require the insertion of a separate breathing tube (endotracheal tube). This intubation can sometimes result in pressure on the vocal cords or the delicate cricoarytenoid joint, leading to temporary vocal cord weakness or immobility. Medical staff employ mitigation strategies like lubricating the scope and carefully monitoring patient positioning to minimize the physical stress on these structures. The use of smaller-diameter scopes and conscious sedation, which avoids the need for a breathing tube, also helps reduce potential mechanical injury to the laryngeal area.
Recognizing Symptoms and Recovery Timeline
The most common side effect following an EGD is a sensation of throat soreness or mild hoarseness, often described as a scratchy throat, which is a temporary result of the scope’s passage. This irritation typically resolves quickly, with most patients experiencing a complete return to normal voice and swallowing function within 24 to 72 hours. Resting the voice, drinking cool liquids, or using throat lozenges can help to soothe this mild discomfort in the immediate recovery period.
More serious symptoms suggest a need for immediate medical consultation, as they can indicate a complication such as a persistent injury or nerve involvement. Signs of a severe issue include intense throat pain that does not improve after three days, a persistent inability to speak or a severely strained voice, or sudden difficulty breathing, known as stridor. In extremely rare instances, pressure from a breathing tube or the scope can cause temporary damage to the recurrent laryngeal nerve, which controls vocal cord movement, leading to vocal cord paresis or paralysis. Should hoarseness or difficulty swallowing persist for longer than a week, a follow-up examination with a specialist, such as an otolaryngologist, may be necessary to assess the vocal cords directly for any underlying injury.