Adverse Events and Time to Diagnosis of In-Office Laryngeal Biopsy Procedures

Abstract

Objective To examine the adverse events and time to diagnosis of in-office laryngeal biopsy (IOB) procedures. Study Design Retrospective cohort study. Setting Outpatient clinic–tertiary referral medical center. Subjects and Methods A total of 390 IOBs were included in this study. Data on demographic characteristics, outcomes, and complications were collected. Complications were classified as severe—necessitating further intervention or admission—or mild and self-limited. Delay in diagnosis, assessed as a complication of IOB, was calculated as the time from initial examination to final diagnosis. Results Of 390 IOBs, 4 (1%) had complications: epistaxis (n = 2), vocal fold hematoma (n = 1), and aspiration event (n = 1). There were no reports of complications at follow-up. The sensitivity of IOB versus direct laryngoscopy biopsies was 77.8%, and the specificity was 95.1%. When the IOB showed malignancy as a final diagnosis, time to diagnosis was 10.7 days (95% CI, 8.6-12.8). When IOB pathology results changed from benign or carcinoma in situ to malignant (squamous cell carcinoma) by direct laryngoscopy, time to diagnosis was longer: 49.1 days (95% CI, 38.1-60.1) and 36.1 days (95% CI, 15.1-57.1; P < .05), respectively. Conclusions In this cohort, IOBs appear to be free of significant adverse events. IOBs for suspicious laryngeal lesions shorten the time to diagnosis and treatment for the majority of patients; the minority showed a small and insignificant delay.