In-office biopsy of upper airway lesions: Safety, tolerance, and effect on time to treatment

• Published in: The Laryngoscope 2015-04, Vol.125 (4), p.919-923
• Main Authors: Lippert, Dylan, Hoffman, Matthew R., Dang, Phat, McCulloch, Timothy M., Hartig, Gregory K., Dailey, Seth H.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ambulatory Surgical Procedures - economics; Ambulatory Surgical Procedures - methods; Analysis of Variance; Biopsy, Needle - economics; Biopsy, Needle - methods; Chi-Square Distribution; Cohort Studies; Cost Savings; Female; head and neck cancer; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Humans; Hypopharyngeal Neoplasms - pathology; Hypopharyngeal Neoplasms - surgery; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - surgery; Laryngoscopy - methods; Logistic Models; Male; Middle Aged; Office biopsy; office procedure; Operating Rooms; Operative Time; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - surgery; Patient Safety; Retrospective Studies; Risk Assessment; Sensitivity and Specificity; upper airway lesions
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.25007

Objectives/Hypothesis Definitive tissue diagnosis for lesions warranting biopsy is shifting from the operating room to the office. Safety, tolerance, factors related to successful biopsy, and time to treatment are not well‐defined. Methods Retrospective review of 116 patients undergoing in‐office biopsy of oropharynx, larynx, or hypopharynx were included. Logistic regression determined if demographics, site, T‐stage, or approach (transoral/transnasal) were related to success. Time to definitive treatment was also analyzed. Results Ninety‐two transnasal and 24 transoral biopsies were performed on 73 laryngeal, 35 oropharyngeal, and 8 hypopharyngeal lesions. Of those, 97 of 116 diagnoses were made in‐office. There were no complications; two patients did not tolerate the procedure. Success was not related to age (P = 0.374), site (P = 0.527), T‐stage (P = 0.587), or approach (P = 0.566). Time to treatment was 24.2 ± 13.9 days with successful office biopsy and 48.8 ± 49.4 days without. Conclusions High procedural completion rate was observed across patients, sites, and approaches. All patients should be considered for in‐office biopsy, a more time‐ and cost‐effective option leading to earlier treatment. Level of Evidence 4. Laryngoscope, 125:919–923, 2015