ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Avoiding the Operating Room: The Advantages of Office-Based Laryngology and Esophagology

by John Austin • August 1, 2006

  • Tweet
  • Email
Print-Friendly Version

CHICAGO-Obviously, there are times when a trip to the operating room is the only option, but more and more physicians are finding that more and more screening, diagnostic, and minimally invasive procedures are best performed in the office setting. Reduced risks, better recovery times, and favorable reimbursement are just a few of the issues that often make many laryngology and esophagology procedures attractive candidates for an office-based approach, according to Albert Merati, MD, Chief of Laryngology, Associate Professor of Otolaryngology and Communication Sciences and Director of the Center for Communication and Swallowing Disorders at the Medical College of Wisconsin in Milwaukee.

You Might Also Like

No related posts.

Explore This Issue
August 2006
Figure. Otolaryngologists-head and neck surgeons are finding many uses for office based laryngology and esophagology techniques. Here, a physician takes a brush biopsy using an endoscope.

click for large version
Figure. Otolaryngologists-head and neck surgeons are finding many uses for office based laryngology and esophagology techniques. Here, a physician takes a brush biopsy using an endoscope.

Dr. Merati served as moderator for a special panel discussion hosted by the American Broncho-Esophageal Association here at the Combined Otolaryngology Spring Meetings (COSM). The panelists discussed some of the key issues related to office-based techniques, including utility of the procedure, equipment needed, indications and contraindications, and the economic implications of various techniques.

Transnasal Flexible Laryngoscopy and Biopsy

Transnasal flexible laryngoscopy (TFL) is commonly used in the office setting to evaluate patients with vocal cord paralysis or vocal fold tumors, but it is also very effective for obtaining tissue for biopsy, said Jonathan Aviv, MD, Professor of Otolaryngology-Head and Neck Surgery and Medical Director of the Voice and Swallowing Center at Columbia University Medical Center in New York City.

The indications for unsedated transnasal flexible laryngoscopy and biopsy are really very broad. We use this as a substitute for intraoperative direct laryngoscopy and biopsy under general anesthesia, Dr. Aviv said. This is not a substitute for laryngeal phonomicrosurgery, be very clear on this. This is for those white lesions and red lesions that you see in the office, that you see at the tongue base and you see in the larynx. We usually follow these things, but why follow them when you can get a definitive tissue diagnosis right away?

Dr. Aviv said his goal is to perform the procedure without the need for any injections, using only a topical anesthesia, typically 2% plain xylocaine, dropped directly on the vocal folds.

Then the instrument we use is a either a disposable brush or disposable biopsy forcep with suction attached, and a flexible laryngoscope that has a working channel, he said. The advantage of the brush is you can biopsy a broad lesion. The disadvantage is you can’t get through the basement membrane and you can’t detect invasion, which you can do with a cup forcep.

Advantages for Patient and Physician

The ability to perform the procedure without the need for general anesthesia, however, is the overriding advantage of office-based laryngoscopy, Dr. Aviv said.

Pages: 1 2 3 4 5 | Single Page

Filed Under: Departments, Laryngology, Medical Education, Practice Focus, Practice Management Tagged With: COSM, injections, laser, office-based, outcomes, patient satisfaction, surgery, techniques, treatment, vocal cordIssue: August 2006

You Might Also Like:

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Some Studies Predict a Shortage of Otolaryngologists. Do the Numbers Support Them?
    • Vertigo in the Elderly: What Does It Mean?
    • Complications for When Physicians Change a Maiden Name
    • Neurogenic Cough Is Often a Diagnosis of Exclusion
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • Tympanoplasty Tips: Otology Experts Give Advice on the Procedure
    • How Treatment for Obstructive Sleep Apnea (OSA) Is Evolving to Give Patients a Better Night’s Sleep
    • Vestibular Schwannoma Position Relative to Internal Auditory Canal Helps Predict Postoperative Facial Function
    • Vocal Fold Lipoaugmentation Provides Long-Term Voice Improvements for Glottal Insufficiency
    • Upper Lateral Cartilage Mucosal Flap Enables the Successful Closure of Larger Septal Perforations

Polls

Do you think there will be a shortage of otolaryngologists in the next five to 10 years?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2022 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.