Transnasal Flexible Laryngoscopy Using Different Topical Preparations and Methods of Application-A Randomized Study

Area of Science:

• Otolaryngology
• Laryngology
• Medical Devices

Background:

• Transnasal flexible laryngoscopy has significantly advanced laryngology.
• Skillful technique ensures optimal visualization of laryngeal structures.

Purpose of the Study:

• To compare the effectiveness of topical agents for patient comfort during flexible laryngoscopy.
• To evaluate agents including 10% lidocaine spray, 2% lidocaine gel, 4% lidocaine with xylometazoline, and aqueous gel.
• To assess ease of endoscope advancement, pain, and discomfort.

Main Methods:

• Prospective randomized single-blinded clinical trial in South India.
• 376 patients were allocated into four groups based on topical preparation.
• Patient and clinician questionnaires using a visual analogue scale assessed experience.

Main Results:

• Pain scores and procedural ease were comparable across groups.
• 10% lidocaine spray caused a significant burning sensation (P=0.0001).
• Other factors like throat pain, gag reflex, and willingness for repeat procedures were comparable.

Conclusions:

• Aqueous gel is a viable topical option for flexible nasopharyngolaryngoscopy.
• It can be used as an alternative to anesthetic agents or combined decongestants.
• Provides comparable patient comfort and procedural outcomes.