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

Refaat, Ahmed; Negm, Ahmed S.

doi:10.1016/j.jvoice.2020.09.001

Cited by 3 publications

(6 citation statements)

References 13 publications

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“…The age group and male to female ratio is consistent with many studies. [8][9][10][11][12] On the contrary Riaz et al has found laryngeal cancer to be the disease of elderly with increasing male preponderance. 10 In US this incidence among males has been decreased from 12:1 to 5:1 over period of ten years.…”

Section: Discussionmentioning

confidence: 99%

To determine the diagnostic accuracy of fiber-optic laryngoscopy in suspected Carcinoma Larynx patients.

Kumar¹,

Rao²,

Kumar

et al. 2023

TPMJ

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Objective: To determine diagnostic accuracy of fiber-optic laryngoscopy in suspected Carcinoma Larynx patients. Study Design: Cross-sectional study. Setting: Department of Ear Nose and throat at People’s Medical College hospital Nawabshah, Sindh. Period: 1st July 2021 to 31st December 2021. Material & Methods: The sample size of the study was 176. The inclusion criteria involved age >20- 60 years, either gender, patients presenting with clinical symptoms of hoarseness of voice, with or without difficulty in swallowing, persistent cough, weight loss for one month, visiting outpatient department. Patients with bleeding disorders were excluded. Results: Out of 176 patients included in the study the mean age of the patients was 36.23± 3.7 years. Mostly the age range of the patients involved 30-35 yrs., n=76(43.2%), the male to female ratio was 1.2:1 (n=98:78) (55.7%: 44.3%). The sensitivity was 89.2%, the specificity was 78.3%, positive predictive value was 70.7%, negative predictive value was 92.5%, diagnostic accuracy was 82.3%. Conclusion: Our study showed that all patients with high suspicion should have undergone diagnostic testing with flexible as well as direct laryngoscopy to diagnose laryngeal cancers at early stage, so that patients benefit with early treatment with high cure rates.

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Section: Discussionmentioning

confidence: 99%

To determine the diagnostic accuracy of fiber-optic laryngoscopy in suspected Carcinoma Larynx patients.

Kumar¹,

Rao²,

Kumar

et al. 2023

TPMJ

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“…Many studies have looked at the sensitivity of office-based laryngeal biopsies, with rates up to 97 per cent. [15][16][17][18][19][20][21][22][23][24] Excellent rates for specificity have been reported in multiple studies ranging from 83 per cent to 100 per cent. [15][16][17][18][19][20][21][22][23][24] A retrospective review on 581 patients by Cha et al 15 showed a sensitivity and specificity of 78.2 per cent and 100 per cent, respectively.…”

Section: Sensitivity and Specificitymentioning

confidence: 95%

“…[15][16][17][18][19][20][21][22][23][24] Excellent rates for specificity have been reported in multiple studies ranging from 83 per cent to 100 per cent. [15][16][17][18][19][20][21][22][23][24] A retrospective review on 581 patients by Cha et al 15 showed a sensitivity and specificity of 78.2 per cent and 100 per cent, respectively. The negative predictive value of malignancy diagnosed on out-patient biopsy was 87.3 per cent, and the positive The Journal of Laryngology & Otology predictive value was 100 per cent.…”

Section: Sensitivity and Specificitymentioning

confidence: 95%

A systematic review on efficacy, safety and cost-effectiveness of office-based laryngeal biopsy

et al. 2022

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Objective Laryngeal cancer is the second most prevalent head and neck malignancy in the USA. With recent advances in technology, this procedure is increasingly performed under local anaesthesia. This study aimed to identify the efficacy, safety and cost-effectiveness of laryngeal biopsy in out-patients by conducting a systematic review. Method A literature search was conducted using PubMed, Medline, Google Scholar and Embase over a 20-year period. Inclusion criteria were: studies performed on out-patient diagnostic biopsy procedures of the larynx. Exclusion criteria included all therapeutic procedures. The outcome measures were sensitivity and specificity, complication rate and cost-savings. Results Thirty-five studies were included in the analysis. The sensitivity and specificity varied from 60 to 100 per cent with a low complication rate and cost savings. Conclusion Office-based laryngeal biopsies are increasingly used in the diagnosis of laryngeal cancers, resulting in earlier diagnosis and commencement of treatment. The barrier to undertaking this procedure is low sensitivity.

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“… 13 , 14 , 15 Biopsy through a transoral or transnasal route has been utilized to obtain pathological tissues of the pituitary, oral cavity, nasopharynx, oropharynx, esophagus, parapharyngeal space, retropharyngeal lymph node, and clivus 16 , 17 , 18 , 19 , 20 , 21 and may therefore elevate the diagnostic accuracy. 21 , 22 , 23 The transoral approach is widely applied and offers direct access to the pathology without neurovascular tissue retraction in craniovertebral junction (CVJ) surgery. 24 In the past 30 years, the TNA has also been extensively utilized in surgery to treat diseases involving the clivus, C1, and C2.…”

Section: Introductionmentioning

confidence: 99%

“…The transnasal endoscopic approach (TNA) and transoral approach (TOA) have recently become two vital options for otolaryngological and neurosurgical interventions 13–15 . Biopsy through a transoral or transnasal route has been utilized to obtain pathological tissues of the pituitary, oral cavity, nasopharynx, oropharynx, esophagus, parapharyngeal space, retropharyngeal lymph node, and clivus 16–21 and may therefore elevate the diagnostic accuracy 21–23 . The transoral approach is widely applied and offers direct access to the pathology without neurovascular tissue retraction in craniovertebral junction (CVJ) surgery 24 .…”

Section: Introductionmentioning

confidence: 99%

Transnasal Endoscopic and Transoral Approaches in the Biopsies of Ventral Atlas and Axis Vertebrae: A Comprehensive Retrospective Study for Preprocedural Scheme, Biopsy Procedure, Core Technique Analysis, Diagnostic Yield and Clinical Outcome

Shao

et al. 2022

Orthopaedic Surgery

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Objective This study aims to describe and analyze the transoral and transnasal approaches for pathologies of the ventral atlas and axis vertebrae, which are considered technically challenging regions for diagnostic biopsy. Methods A series of transnasal endoscopic approach (TNA) and transoral approach (TOA) biopsies for the pathologies of the first and second cervical vertebrae were conducted and retrospectively analyzed from July 2014 to May 2021. The depth of the biopsy trajectory was measured on computed tomography images for all nine patients (eight males and one female with an average age of 58.11 ± 11.60 years), as were the coronal, sagittal, and vertical biopsy safe ranges. The characteristics of each lesion, including radiographic features, blood supply, and destruction of anterior or posterior vertebral body edges, were evaluated to guide the biopsy. Four biopsy core techniques (BCTs), including “lesion perforating”, “aspiration”, “cutting‐and‐scraping” and “biopsy forceps utilization” were elaborated in this study. The biopsy procedures and periprocedural precautions were demonstrated. Patient demographics, clinical data, lesion characteristics, diagnostic yield, and complications were recorded for each case. Results Eight TOA biopsies for the axis vertebral body and one TNA biopsy for the atlas anterior arch were successfully performed and yielded adequate pathologies. All biopsies were organized based on the preprocedural radiographic measurements, which showed that the average length of biopsy trajectory and coronal, sagittal, and vertical safe biopsy ranges were 85.00 ± 5.88, 20.63 ± 4.75, 16.25 ± 1.49, and 24.63 ± 2.26 mm, respectively, and these corresponding data were 95, 36, 9, and 26 mm in the TNA patient. Six osteolytic lesions (66.7%), one osteoblastic lesion (11.1%), and two mixed lesions (22.2%) were observed, among which seven lesions had a rich blood supply. Biopsy forceps and core needles were utilized to obtain samples in six and three patients, respectively. All the TNA and TOA biopsies were performed with cooperative application of multiple BCTs under compound anatomic and stereotactic navigations. Intraprocedural or postprocedural complications occurred in no patients who underwent the biopsy in the follow‐up period (1–39 months). No significant differences were found between the preprocedural and postprocedural blood indexes and visual analogue scale scores. Conclusion With a sophisticated preprocedural arrangement, cooperative application of BCTs, and careful periprocedural precautions, transnasal endoscopic and transoral biopsies are two feasible, efficient, and well‐tolerated procedures that achieve satisfactory diagnostic yield, complication rate, and clinical outcome.

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

Cited by 3 publications

References 13 publications

To determine the diagnostic accuracy of fiber-optic laryngoscopy in suspected Carcinoma Larynx patients.

To determine the diagnostic accuracy of fiber-optic laryngoscopy in suspected Carcinoma Larynx patients.

A systematic review on efficacy, safety and cost-effectiveness of office-based laryngeal biopsy

Transnasal Endoscopic and Transoral Approaches in the Biopsies of Ventral Atlas and Axis Vertebrae: A Comprehensive Retrospective Study for Preprocedural Scheme, Biopsy Procedure, Core Technique Analysis, Diagnostic Yield and Clinical Outcome

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