Digital Video Laryngoscopy and Flexible Endoscopic Biopsies as an Alternative Diagnostic Workup in Laryngopharyngeal Cancer

A Prospective Clinical Study

Schutte, Henrieke W. MD
Takes, Robert P. MD, PhD
Slootweg, Piet J. MD, PhD
Arts, Marianne J.P.A.
Honings, Jimmie MD, PhD
van den Hoogen, Frank J.A. MD, PhD
Marres, Henri A.M. MD, PhD
van den Broek, Guido B. MD, PhD

¹Department of Otorhinolaryngology and Head & Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
²Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands

Henrieke W. Schutte, MD, Department of Otorhinolaryngology and Head & Neck Surgery, Radboud University Medical Center, PO Box 9101, Nijmegen, 6500 HB, the Netherlands. Email: [email protected]

Annals of Otology, Rhinology & Laryngology 127(11):p 770-776, November 2018. | DOI: 10.1177/0003489418793987

Objectives:

An office-based workup strategy for patients with laryngopharyngeal lesions suspicious for carcinoma is analyzed. The feasibility of office-based transnasal flexible endoscopic biopsies under local anesthesia and the impact on the diagnostic workup are evaluated.

Methods:

This study is a prospective analysis of patients with laryngeal, oropharyngeal, and hypopharyngeal lesions suspicious for carcinoma. One hundred eighty-eight participants were divided into 2 groups. The first group underwent an office-based biopsy procedure under local anesthesia using a flexible digital video laryngoscope with instrument channel (n = 53), and the second group underwent a biopsy procedure under general anesthesia using rigid laryngopharyngoscopy (n = 135).

Results:

Office-based flexible endoscopic biopsies were tolerated well, and there were no complications. These biopsies were 92.5% successful in acquiring a definitive diagnosis. Costs were reduced. Diagnostic workup time and time until start of therapy were reduced to 2 days and 27 days, respectively.

Conclusion:

Office-based biopsy under local anesthesia using flexible digital video laryngoscopy is safe, cost-effective, and successful in providing a histopathological diagnosis. It reduces the diagnostic workup time significantly in patients with laryngeal, oropharyngeal, and hypopharyngeal cancer, while also reducing the necessity to subsequently perform a rigid laryngopharyngoscopy under general anesthesia.