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

Cha, Wonjae; Yoon, Byung-Woo; Jang, Jeon Yeob; Lee, Jin Choon; Lee, Byung‐Joo; Wang, Soo-Geun; Cho, Jae Keun; Cho, Ilyoung

doi:10.1002/lary.25930

Cited by 18 publications

(34 citation statements)

References 9 publications

(68 reference statements)

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“…As has been observed with other office‐based laryngology procedures, procedure completion rate was high. This was despite several patients either having a diagnosis of generalized anxiety disorder or self‐reporting anxiety related to procedures.…”

Section: Discussionsupporting

confidence: 74%

Serial office‐based steroid injections for treatment of idiopathic subglottic stenosis

2017

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Section: Discussionsupporting

confidence: 74%

Serial office‐based steroid injections for treatment of idiopathic subglottic stenosis

2017

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“…However, and unlike our study, not all the cases have a confirmatory direct operating room laryngeal biopsy which is the gold standard. [12] The higher diagnostic accuracy and sensitivity of the trans-oral approach in the results of our study is in accordance with the study ofHassan et al (2018) which showed a 100% sensitivity and 75.6% specificity. [13] Healing after office-based superficial laryngeal biopsies generally takes places very quickly and voice rest is not typically required after the procedure [14].…”

Section: Discussionsupporting

confidence: 93%

“…In retrospective analysis, some studies reported somewhat different results as 60% sensitivity and 87% specificity. [8][9][10][11] In a retrospective analysis of consecutive 581 cases, office-based biopsies via trans-nasal approach for laryngeal lesions were evaluated by Cha et al (2016) and the results showed sensitivity of 78.2% and a specificity of 100.0%. However, and unlike our study, not all the cases have a confirmatory direct operating room laryngeal biopsy which is the gold standard.…”

Section: Discussionmentioning

confidence: 99%

Trans-oral versus trans-nasal approach in office-based laryngeal biopsy; a cohort-selection cross-sectional diagnostic accuracy study.

Refaat

Negm

2020

Preprint

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Objective: The aim of this study is to explore the accuracy of two different approaches; trans-oral versus trans-nasal officebased laryngeal biopsy. Methods: The study was a cohort-selection cross-sectional study that included all patients aged 18 years or more with suspicious lesions of the larynx or the oropharynx who came to the outpatient clinic [removed for blind peer review], due to different reasons during the period of March 2017 and March 2020. Full evaluation was done using Flexible naso-endoscope with distal chip. Patients with suspicious lesions were referred for office-based-based biopsy; either trans-nasal biopsy or trans-oral biopsy; to determine whether the lesion was malignant or benign. Then, all patients were referred for subsequent direct laryngoscopy for definitive diagnosis. Both groups were compared for all demographic variables as well as clinic-pathologic variables and for diagnostic accuracy. Results: The overall sample was 60 cases; 30 in each group. Both groups are comparable with regard the age and gender (p-values > 0.05). The majority in both groups are smokers (83.3 & 76.7%). The most frequent cause of referral for biopsy was suspicious laryngeal mass in both groups; mentioned in 80.0% of both groups (p-value 0.736). The number of biopsies obtained was significantly higher in the trans-oral group (3.7 ± 1.0) than in the trans-nasal group (3.1 ± 0.9), (p-value = 0.013). Both approaches were tolerated by all patients with few limited aspiration or epistaxis. The trans-oral approach has a higher Chohen kappa index (0.79) than the trans-nasal approach (0.14). Also, it has got higher diagnostic accuracy (93.3%) than the trans-nasal approach (50.0%). The sensitivity of trans-oral approach biopsies compared with that of direct laryngoscopy biopsies was 95.8% and the specificity was 83.3%. On the other hand, the sensitivity of trans-nasal approach biopsies compared with that of direct laryngoscopy biopsies was 26.3% and the specificity was 90.9%. Conclusion: The trans-oral approach to obtain a biopsy from the upper aero-digestive tract has better diagnostic accuracy than the trans-nasal approach. When combined with trans-nasal visualization and transcricothyroid anesthesia. Succinct Keypoints: Trans-nasal approach; trans-oral approach; office-based laryngeal biopsy; sensitivity; specificity; diagnostic accura Trans-oral versus trans-nasal approach in office-based laryngeal biopsy; a cohort-selection cross-sectional diagnostic accuracy study. Keypoints: 1. Office base laryngeal biopsy has been increasingly spreading around the world. 2. Benefits from office based procedures including time saving and avoidance of general anesthesia and saving of hospital cost. 3. Short description of the setting and tools and approaches used in office based biopsy. 4. Short description of the types of local anesthesia used. 5. Transoral approach in obtaining biopsy has a higher sensitivity and specificity.

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“…However, and unlike our study, not all of Cha's cases had a confirmatory direct operating room laryngeal biopsy as the gold standard. 12 The higher diagnostic accuracy and sensitivity of the transoral approach in the results of our study agrees with Hassan et al, which showed 100% sensitivity and 75.6% specificity. 13 Healing after office-based superficial laryngeal biopsies generally takes places very quickly, and a voice rest is not typically required after the procedure.…”

Section: Pre-and Postprocedures Precautionssupporting

confidence: 92%

Transoral Versus Transnasal Approaches in Office-Based Laryngeal Biopsy: A Cohort-Selection Cross-Sectional Diagnostic Accuracy Study

Refaat

Negm

2022

Journal of Voice

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

Abstract: 4. Laryngoscope, 126:2513-2519, 2016.

Cited by 18 publications

References 9 publications

Serial office‐based steroid injections for treatment of idiopathic subglottic stenosis

Serial office‐based steroid injections for treatment of idiopathic subglottic stenosis

Trans-oral versus trans-nasal approach in office-based laryngeal biopsy; a cohort-selection cross-sectional diagnostic accuracy study.

Transoral Versus Transnasal Approaches in Office-Based Laryngeal Biopsy: A Cohort-Selection Cross-Sectional Diagnostic Accuracy Study

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