Many Laryngeal Biopsies Can Be Performed In-Office

It is not difficult to set up the equipment needed to perform in-office biopsies. You need a video camera to add to your flexible fiberoptic laryngoscope, a video monitor to view the video, and, ideally, a recording mechanism. With the advent of add-on disposable sheaths that have a side port, no new special endoscope is required, Dr. Johns said.

Sheaths are a relatively new development that has added to the safety of the procedure by reducing the risk of contamination. Many scopes have a channel through which biopsy forceps are passed, and this channel is difficult to clean, according to Dr. Wallace. But, if you use a sheath, you can just go through the sheath out and clean the scope in a normal way, he said.

When starting out, otolaryngologists should start small and work their way up. I would start with a small lesion just to get a hang on the hand-eye coordination with the biopsy forceps being just off the center of the scope, and work your way to where your comfort level is, Dr. Wallace said. Overall, being able to do this procedure in-office is easier for both the patient and the otolaryngologist.

©2009 The Triological Society