I should have added that "direct visualization" also includes other things such as a nasolaryngoscope (from time to time - fiber optic down the nose), long specialized mirrors (typically preheated to prevent fogging over) and also palpation, which is the gloved hand down the throat and checking the lymph nodes externally. Some or all of these are typical post Tx followup. They are no big deal and I am glad that someone is checking. This is considered the gold standard for H&N followup - along with an annual chest x-ray. Some here do get regular PET or PET/CT's as well but it is not in the NCCN oncology practice guidelines so it may be an institutional protocol or, conversely, insurance companies won't pay for it.