Perception and duration of pain after office‐based vocal fold injection augmentation

Crawley, Brianna K.; Dehom, Salem; Kutzner, Emily; Murry, Thomas; Krishna, Priya; Hata, Justin

doi:10.1002/lary.27061

Cited by 14 publications

(33 citation statements)

References 20 publications

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“…Similarly, Taliercio et al 20 reported that 76% described sore throat persisting for 3 postoperative days; 36% reported sore throat persisting beyond POD 3. Crawley et al 14 showed a similar phenomenon in their study of postprocedural pain after in-office vocal fold injection. A significant number of patients had pain a week after the procedure, also measured by the SF-MPQ.…”

Section: Discussionmentioning

confidence: 69%

Patient Perception and Duration of Pain after Microdirect Laryngoscopy

Tsang

Brett

2020

Otolaryngol.--head neck surg.

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Objective Postoperative pain is an important part of the patient’s surgical experience. The objective was to evaluate patient perception and duration of pain after microdirect laryngoscopy (MDL). Study Design Case series with planned data collection. Setting Tertiary care, academic center. Subjects and Methods Adult patients undergoing MDL were administered the short-form McGill Pain Questionnaire (SF-MPQ) before surgery and on postoperative days (PODs) 1, 3, and 7. Demographic and clinical data were collected. Results In total, 130 patients (mean age 52.6 years, 84 male) participated in the study. About 46.2% required analgesia on POD 1, but only 23.1% required opioids. Overall, mild levels of pain were reported on the SF-MPQ: sensory score, affective score, total score, present pain intensity (PPI), and visual analog scale (VAS). Patients reported a significant increase in pain on POD 1, with decreases in pain on PODs 3 and 7. Pain score returned to preoperative values for total score and affective score on POD 7 but remained significantly elevated for PPI, VAS, and sensory score. None of the following factors were associated with increased pain: age, sex, body mass index, Mallampati score, Cormack score, laryngoscope used, type of MDL, time under anesthesia, employment status, intubation, Voice Handicap Index 10, and chronic pain history. Conclusion Although mild levels of pain were reported after MDL, the pain persisted for up to 7 days. No demographic or clinical factors were found to be associated with increased pain. This study was one of the few prospective studies evaluating pain after MDL.

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Section: Discussionmentioning

confidence: 69%

Patient Perception and Duration of Pain after Microdirect Laryngoscopy

Tsang

Brett

2020

Otolaryngol.--head neck surg.

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“…Of the included studies, 9 were prospective randomized trials, 15-23 4 were prospective nonrandomized cohort studies, 24-27 47 were prospective case series, 28-74 22 were retrospective reviews, 75…”

Section: Resultsmentioning

confidence: 99%

“…30,36,53,58,84 The Wong-Baker FACES scale was used in 2 studies 46,87 and the McGill Pain Questionnaire in 2 as well. 38,63 The Iowa Satisfaction with Anesthesia Scale was used by a single study. 66 Patient tolerance—as assessed via a patient’s ability to complete the entirety of a procedure—was the primary pain assessment method in 22 studies † and was reported as a secondary assessment of postprocedural pain in 2 additional studies.…”

Section: Resultsmentioning

confidence: 99%

“…¶ Two of the studies using a nonvalidated numerical scale also used nonstandard verbal anchors, with adjectives applied beyond the standard greatest and least numeric values. 45,97 Qualitative pain assessment was undertaken in only 3 studies 38,45,63 and a baseline, preprocedural pain assessment in only 5 studies. 15,38,44,65,87 Only 1 study included baseline pain medication usage, and no studies mentioned the presence or absence of other pain syndromes.…”

Section: Resultsmentioning

confidence: 99%

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Assessment and Treatment of Pain during In‐Office Otolaryngology Procedures: A Systematic Review

Frank

Carlson

et al. 2019

Otolaryngol.--head neck surg.

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Objective To qualitatively assess practices of periprocedural pain assessment and control and to evaluate the effectiveness of interventions for pain during in-office procedures reported in the otolaryngology literature through a systematic review. Data Sources PubMed, CINAHL, and Web of Science searches from inception to 2018. Review Methods English-language studies reporting qualitative or quantitative data for periprocedural pain assessment in adult patients undergoing in-office otolaryngology procedures were included. Risk of bias was assessed via the Cochrane Risk of Bias or Cochrane Risk of Bias in Non-Randomized Studies of Interventions tools as appropriate. Two reviewers screened all articles. Bias was assessed by 3 reviewers. Results Eighty-six studies describing 32 types of procedures met inclusion criteria. Study quality and risk of bias ranged from good to serious but did not affect assessed outcomes. Validated methods of pain assessment were used by only 45% of studies. The most commonly used pain assessment was patient tolerance, or ability to simply complete a procedure. Only 5.8% of studies elicited patients’ baseline pain levels prior to procedures, and a qualitative assessment of pain was done in merely 3.5%. Eleven unique pain control regimens were described in the literature, with 8% of studies failing to report method of pain control. Conclusion Many reports of measures and management of pain for in-office procedures exist but few employ validated measures, few are standardized, and current data do not support any specific pain control measures over others. Significant opportunity remains to investigate methods for improving patient pain and tolerance of in-office procedures.

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“…A recent study tracked patient pain levels during and following in-office procedures and suggested that stretched tissues may cause increased or longer durations of pain. 20 The ability to harness the findings of this study to produce streamlined injection procedures may reduce procedural time and stretching or damage to surrounding tissue from efforts to maintain needle stability during injection laryngoplasty. These results may also translate to other procedures that use these materials.…”

Section: Discussionmentioning

confidence: 98%

Quantification of injection force mechanics during injection laryngoplasty

Pearson

Ortiz²,

Montelongo

et al. 2018

The Laryngoscope

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Objectives In‐office or operative injection laryngoplasty requires needle stability for accurate material placement. To date, no reports compare injection forces based on needle gauge, bends, length, or material type or temperature. We hypothesize these factors alter injection forces and could impact clinical use. Methods Swine larynges were placed in a compression testing machine. Syringes were affixed to a stabilizing crossbeam. Straight needles (25G 1.5‐inch; 27G 1.25‐inch; or 9.8‐inch malleable shaft 16G per oral with 24G tapered needle tip) were inserted into the swine vocal folds to simulate realistic tissue resistance pressure. Compressive loading was conducted at 40 mm/minute until steady‐state force was achieved. Tests were completed with calcium hydroxylapatite (CaHa), carboxymethylcellulose, and hyaluronic acid at various temperatures and CaHa with various bends in the needles (n = 3 per group, comparisons performed by two‐way analysis of variance (ANOVA), Tukey's post‐hoc). Results Needle size, shape, and temperature altered injection force. Steady‐state force was highest with the per‐oral needle at a mean of 44.55N compared to 26.44N and 29.77N in the 25G and 27G percutaneous needles, respectively (P < 0.001). Stiffness rate (initial increasing force vs. distance to initiate injection) ranged from 19.75N/mm (per oral) to 22.06N/mm (25G) to 24.56N/mm (27G), (P = 0.875). Adding multiple bends to the per‐oral needle increased stiffness rate to 24.99N/mm (P = 0.035), whereas the 25G needle stiffness rate remained unchanged (P = 0.941), with the stiffness rate decreasing in the 27G needle with increasing bends (P = 0.033). Increased temperature decreased injection forces across all materials. Conclusion Needle caliber, length, and bends impact steady‐state forces and stiffness rates during vocal fold injection. Level of Evidence NA Laryngoscope, 129:1060–1066, 2019

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Perception and duration of pain after office‐based vocal fold injection augmentation

Abstract: 4. Laryngoscope, 128:929-934, 2018.

Cited by 14 publications

References 20 publications

Patient Perception and Duration of Pain after Microdirect Laryngoscopy

Patient Perception and Duration of Pain after Microdirect Laryngoscopy

Assessment and Treatment of Pain during In‐Office Otolaryngology Procedures: A Systematic Review

Quantification of injection force mechanics during injection laryngoplasty

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