Abstract
BackgroundThe advent of chip tip technology combined with advanced endoscopy has revolutionized the field of laryngology in the past decade. Procedures such as transnasal esophagoscopy, site-specific steroid injections, injection laryngoplasty and laryngeal laser treatment can now be performed in the office setting under local anaesthesia. Although In-Office Laryngeal Procedures (IOLPs) have become standard-of-care in many American and several Canadian centers, there are no guidelines regulating the practice of these procedures. The goal of this report was to evaluate the current method of IOLP delivery in Canada.MethodsAn electronic survey was dispersed to 22 practicing Canadian laryngologists to assess safety and procedural care measures undertaken when performing IOLP. The survey consisted of 37 questions divided into 6 categories; 1) Demographic data 2) Facilities 3) Staff/personnel 4) Patient screening/monitoring 5) Procedure and emergency equipment 6) Reporting of adverse events.ResultsData was collected for 16/22 laryngologists (72.7% response rate). Only 1 respondent did not perform IOLP. All performed injection augmentation laryngoplasty. Most performed laryngeal biopsies, intramuscular injection and/or electromyography guided injection for the treatment of spasmodic dysphonia and glottic/subglottic steroid injections. Only 4 respondents performed in-office KTP laser. Significant variation was found in procedural processes including intra procedural monitoring, anticoagulation screening, access to emergency equipment and documentation.ConclusionOur survey demonstrates that the delivery of IOLP in Canada varies considerably. The construct of IOLP practice guidelines based on the evidence with consistent documentation would promote safe, efficient and quality care for patient with voice disorders.
Highlights
The advent of chip tip technology combined with advanced endoscopy including port access has revolutionized the field of laryngology in the past decade [1,2,3,4]
In patients with significant comorbidities or anatomic limitations who are not suitable or are at a high risk of complications to undergo a general anaesthetic with suspension laryngoscopy, In-Office Laryngeal Procedures (IOLPs) is a viable alternative to treatment which was not available previously
1 respondent did not perform IOLP despite fellowship training due to concerns raised from their hospital administration about safety for these procedures
Summary
The advent of chip tip technology combined with advanced endoscopy has revolutionized the field of laryngology in the past decade Procedures such as transnasal esophagoscopy, site-specific steroid injections, injection laryngoplasty and laryngeal laser treatment can be performed in the office setting under local anaesthesia. The advent of chip tip technology combined with advanced endoscopy including port access has revolutionized the field of laryngology in the past decade [1,2,3,4]. Procedures such as laryngeal biopsies, transnasal esophagoscopy, steroid injection, injection augmentation and laryngeal laser treatment can be performed in the office setting on awake patients with videoendoscopic guidance. In patients with significant comorbidities or anatomic limitations who are not suitable or are at a high risk of complications to undergo a general anaesthetic with suspension laryngoscopy, IOLP is a viable alternative to treatment which was not available previously.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have