One drawback with the microscope is that, since surgery is done through the narrow laryngoscope, the upper parts of the various surgical instruments can block one's view. Special laryngeal telescopes can, in contrast, be placed just above the vocal folds and give unobstructed views of the folds. The photo to the right shows an example of microlaryngeal surgery using a microscope. In this photo the surgeon is actually just focusing in on his thumbs in order to make sure everything is adjusted properly. Note also that the laryngoscope is attached to a special stand that holds it in the proper position.
Various manufacturers offer specialized instruments used for operating on the larynx.
These instruments have a variety of different tips for grasping, cutting, or dissecting tissue. They have to be long and narrow since all surgery is done through the laryngoscope. The ends must be very small, usually only 1 or 2 mm, since the structures on the vocal folds are also tiny The photograph above shows an example of a microlaryngeal scissors. The insert on the lower left shows two other types of tips that are present on other instruments. The surgeon will also commonly use suction catheters and long thin probes or knives to complete the operation.