Office-based flexible endoscopic guided biopsy: single-center feasibility analysis.

Area of Science:

• Otolaryngology
• Endoscopy
• Oncology

Background:

• Direct laryngoscopy with biopsy is the standard for upper aerodigestive tract (UADT) lesions but often requires general anesthesia.
• Office-based flexible guided biopsy presents a less invasive alternative for UADT biopsies.

Purpose of the Study:

• To evaluate the diagnostic yield, accuracy, feasibility, and safety of office-based flexible fiber-optic endoscope-directed biopsy (FEB) for laryngeal and pharyngeal lesions.

Main Methods:

• A retrospective cohort study of FEB procedures was conducted at a tertiary care referral center between June and December 2022.
• The study included 181 consecutive patients with various UADT lesions.

Main Results:

• FEB confirmed malignancy in 166/181 patients, achieving an overall diagnostic accuracy of 87.29%.
• The procedure showed high sensitivity (86.8%) and specificity (100%), with a low conversion rate to direct laryngoscopy (7.73%).
• Minor complications occurred in 14.28% and major complications in 5.9% of procedures.

Conclusions:

• Office-based flexible fiber-optic biopsy is a viable alternative to direct laryngoscopic biopsy for UADT lesions.
• Proper use of FEB can decrease the necessity for direct laryngoscopy, improving patient comfort and potentially reducing healthcare costs.