Laryngeal videoendoscopic surgery under local anesthesia on day outpatient basis

Abstract

Surgery and biopsy for laryngeal/hypopharyngeal lesions under local anesthesia by inserting a flexible endoscope nasally and forceps orally are minimally-invasive and can be performed on an outpatient basis. In our department, these are performed either by 2 medical professionals, a surgeon and an assistant, or a surgeon alone. We evaluated the efficacy and safety of this transoral laryngeal endoscopic surgery. The study included 78 patients who underwent this technique under local anesthesia at the Department of Otolaryngology, Nagasaki University Hospital between January 2015 and November 2019. The primary disease in 79 patients was laryngeal/hypopharyngeal disease (33 with tumors, 16 unilateral vocal cord paralysis, 8 vocal cord polyps, 7 laryngeal granulomas, 5 vocal cord nodules, and 10 with other). Results showed a total of 143 procedures (3 duplicates) performed, including 79 vocal cord infusions, 35 biopsies, 24 tumor resections, 4 cystotomies, and 1 laser vaporization, with 83 procedures performed by 2 medical professionals including an assistant and 57 performed by a surgeon alone, and high completion rates of 98.8% and 94.7%, respective. Complications included laryngeal edema and vasovagal reflex in one patient each ; however, both were mild. This surgical method was thus considered to be effective and safe.