Laryngology Outpatient Procedures Review In A Specialized Tertiary
Institution.
Abstract
Background: Office based laryngeal procedures have dramatically changed
the management of many laryngeal procedures. Such practice offers
advantages to patients, surgeons and institutions. From patients
perspective it has the benefit of eliminating the risk of general
anaesthesia completely, most especially in patients with significant
co-morbid conditions, or those in need of repeated procedures as
recurrent laryngeal papillomatosis. Moreover, it allows titration of
amount of injection required during vocal fold injections as it’s effect
on patients voice can be instantly heard and assess during injection.
This also minimise the risk of over injection and stridor. In addition,
it is cost-effective to institutions and saves theatres’ slots. It also
allows patients to return to normal activities sooner compared to
surgery under a general anaesthesia. Aim: Review of outpatient based
laryngology procedures in Manchester Royal infirmary and determining
patients’ tolerance to outpatient procedures using pain score for the
nose and throat. Study Design: This is a retrospective study of the
outpatient based laryngology procedures under local anesthesia in
Manchester Royal Infirmary, Department of Ototrhinolaryngology, Head and
Neck Surgery from January 2018 till June 2019. Results: Eighty-eight
outpatients procedures recorded during that time period, including
trans-nasal laryngoscopy laser vocal fold procedures, biopsies, vocal
fold injections augmentation, trans-nasal oesophagoscopy and biopsy, and
balloon dilatation. Other procedures recorded were laryngeal EMG and
Trans-nasal oesophagoscopy and tracheo-esophageal puncture for speech
valve insertion. Average pain scores from all procedures according to
pain score from 0-10, revealed average score of 2.71 ±0.87 in the nose
and 3.35 ±0.99 in the throat. There were no recorded complications.
Conclusion: Laryngeal outpatients procedures are generally safe to
perform and well tolerated by patients. In addition to being
cost-effective for hospitals and institutions. Keywords: Office based
procedures, Trans-nasal laryngoscopy, Balloon dilatation, Vocal fold
Injection, Office based laser procedures