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Laryngology Outpatient Procedures Review In A Specialized Tertiary Institution.

Background: Office based laryngeal procedures have dramatically changed the management of many laryngeal procedures. Such practice offers advantages to patients, surgeons and institutions. From patients perspective it has the benefit of eliminating the risk of general anaesthesia completely, most especially in patients with significant co-morbid conditions, or those in need of repeated procedures as recurrent laryngeal papillomatosis. Moreover, it allows titration of amount of injection required during vocal fold injections as it’s effect on patients voice can be instantly heard and assess during injection. This also minimise the risk of over injection and stridor. In addition, it is cost-effective to institutions and saves theatres’ slots. It also allows patients to return to normal activities sooner compared to surgery under a general anaesthesia. Aim: Review of outpatient based laryngology procedures in Manchester Royal infirmary and determining patients’ tolerance to outpatient procedures using pain score for the nose and throat. Study Design: This is a retrospective study of the outpatient based laryngology procedures under local anesthesia in Manchester Royal Infirmary, Department of Ototrhinolaryngology, Head and Neck Surgery from January 2018 till June 2019. Results: Eighty-eight outpatients procedures recorded during that time period, including trans-nasal laryngoscopy laser vocal fold procedures, biopsies, vocal fold injections augmentation, trans-nasal oesophagoscopy and biopsy, and balloon dilatation. Other procedures recorded were laryngeal EMG and Trans-nasal oesophagoscopy and tracheo-esophageal puncture for speech valve insertion. Average pain scores from all procedures according to pain score from 0-10, revealed average score of 2.71 ±0.87 in the nose and 3.35 ±0.99 in the throat. There were no recorded complications. Conclusion: Laryngeal outpatients procedures are generally safe to perform and well tolerated by patients. In addition to being cost-effective for hospitals and institutions. Keywords: Office based procedures, Trans-nasal laryngoscopy, Balloon dilatation, Vocal fold Injection, Office based laser procedures