A cardiovascular prescreening protocol for unmonitored in‐office laryngology procedures

Madden, Lyndsay L.; Ward, John W.; Ward, Anne; Young, Vy Vy N.; Smith, Libby J.; Lott, David G.; Bryson, Paul C.; Clary, Matthew S.; Weissbrod, Phillip A.; Bock, Jonathan M.; Blumin, Joel H.; Rosen, Clark A.

doi:10.1002/lary.26481

Cited by 9 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, other institutions may vary in patient selection, criteria to define a complication, as well as differences between surgeons. Hemodynamic changes during in‐office laryngology procedures have been described; we did not use any prescreening protocol . In addition, the tolerability of the procedure was not quantified with a questionnaire or with physiologic monitoring , which would have allowed for improved assessment of patient tolerance.…”

Section: Discussionmentioning

confidence: 99%

“…Hemodynamic changes during in-office laryngology procedures have been described; we did not use any prescreening protocol. 22 In addition, the tolerability of the procedure was not quantified with a questionnaire or with physiologic monitoring, which would have allowed for improved assessment of patient tolerance. The retrospective design of the study leads to the possibility for selection bias because patients receiving in-office dilation may be healthier at baseline than those dilated in the OR.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Office‐based esophageal dilation in head and neck cancer: Safety, feasibility, and cost analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Office‐based esophageal dilation in head and neck cancer: Safety, feasibility, and cost analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Although there are no published guidelines in laryngology, several authors have recommended some measures to promote patient safety. Madden et al suggested a cardiovascular pre-screening tool to prevent avoidable complications for high risk patients [ 19 ]. The protocol consists of measuring vital signs at the pre-operative appointment to screen patients and refer to the appropriate physician before exposing patients to avoidable risks.…”

Section: Discussionmentioning

confidence: 99%

In-office laryngeal procedures (IOLP) in Canada: current safety practices and procedural care

Bensoussan

Anderson

2018

J of Otolaryngol - Head & Neck Surg

View full text Add to dashboard Cite

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.Electronic supplementary materialThe online version of this article (10.1186/s40463-018-0270-2) contains supplementary material, which is available to authorized users.

show abstract

“…Although there are no published guidelines in laryngology, several authors have recommended some measures to promote patient safety. A cardiovascular pre-screening tool for high risk patients to prevent avoidable complications was proposed by Madden et al, 16 consisting of measuring vital signs at the preoperative appointment to screen patients and refer to the appropriate physician before exposing patients to avoidable risks. Yung and Courey also suggested the monitoring of vitals during these procedures after reporting significant changes in blood pressure and heart rate.…”

Section: Application Of Laser Precautionsmentioning

confidence: 99%

Office Laser Laryngology: A Paradigm Shift

Hantzakos

Khan²

2020

Ear Nose Throat J

View full text Add to dashboard Cite

Objectives: To present the value of office-based laryngological procedures as an effective alternative method to the treatment of benign and malignant laryngeal pathologies. Methods: We have reviewed the technological advancements of fiber-guided laser systems, fiberoptic endoscopes, and high-definition imaging systems that have enabled office-based laryngological procedures. We describe the importance of case and patient selection, the available laser systems, and the technique applied. Results: Several benign and malignant pathologies can be now treated in the office under local anesthesia with angiolytic or thermocoagulative lasers and with success rate comparable to that of general anesthesia. Safety guidelines and laser precautions must be implemented invariably to protect the patient and caregivers from the untoward effects of laser. Although there is considerable reduction of cost with office procedures, there are risks of undertreatment, increased repeatability, as well as tissue edema from the burning effect. Conclusions: The low learning curve, high patient satisfaction rate, and excellent results indicate that in-office laser procedures have become an effective weapon in our armamentarium.

show abstract

A cardiovascular prescreening protocol for unmonitored in‐office laryngology procedures

Abstract: 2b Laryngoscope, 127:1845-1849, 2017.

Cited by 9 publications

References 21 publications

Office‐based esophageal dilation in head and neck cancer: Safety, feasibility, and cost analysis

Office‐based esophageal dilation in head and neck cancer: Safety, feasibility, and cost analysis

In-office laryngeal procedures (IOLP) in Canada: current safety practices and procedural care

Office Laser Laryngology: A Paradigm Shift

Contact Info

Product

Resources

About