In‐office cup biopsy and laryngeal cytology versus operating room biopsy for the diagnosis of pharyngolaryngeal tumors: Efficacy and cost‐effectiveness

Abstract

In-office biopsy is a more affordable technique that enables histologic diagnosis of pharyngolaryngeal lesions in a large percentage of patients.

Safety of flexible endoscopic biopsy of the pharynx and larynx under topical anesthesia

“…In retrospect, the fourth case may not have had a compromised airway during biopsy, but he did have a compromised airway, which required a tracheotomy, when he was admitted to the emergency department. In some studies, anticoagulant use was considered a relative contraindication; patients were advised to stop anticoagulation use, defer the procedure, or they were excluded from further analysis [6, 7, 14, 15]. In the current study, anticoagulant use was not considered a contraindication and it was reported in 29.9% of the patients who underwent FEB. One of four patients (25%) with a complication in this cohort used anticoagulants but did not develop bleeding.…”

“…The histology result of laryngeal FEB was positive for malignancy (i.e., malignant result), negative for malignancy (i.e., nonmalignant result), or non-diagnostic. A non-diagnostic result could occur when it was impossible to obtain a biopsy specimen or when no histological diagnosis could be determined in case of superficially obtained tissue [15]. In the case of an established malignancy, the treatment could be determined by the multidisciplinary tumor board immediately.…”

“…Office-based laryngeal FEB is reported to be safe [6, 12–14], feasible [6], cost-effective [12, 15], and easy to perform [13, 16]. The advantages are an awake patient who is sitting in an upright position and able to control laryngeal function during the procedure, which can result in adequate visualization of the designated lesion [10].…”

“…Furthermore, there is avoidance of general anesthesia with possible health benefits [14, 17]. Its costs are relatively low compared with examination and biopsy under general anesthesia [12, 15]. Most importantly, FEB can often be performed during the initial outpatient visit or follow-up visit, which results in reduced diagnostic delay [7, 18].…”

Office‐based biopsies for laryngeal lesions: Analysis of consecutive 581 cases

“…Nevertheless, the routine use and interpretation of OBB are controversial . Cohen et al recommended the verification with ORB when the pathology of OBB was reported as benign or premalignancy.…”