Correlation between Obesity and Patient Tolerance to Office-Based Trans-Nasal Laryngeal Procedures

To examine the correlation between obesity and patient tolerance to office-based laryngeal procedures (OBLP) using multiple indices for obesity.

Retrospective chart review METHODOLOGY: The medical records of all patients who underwent OBLP via the trans-nasal approach between February 2025 and September 2025 were reviewed. OBLP were divided into three categories: laryngeal biopsy, laser therapy with or without intralesional steroid injection, and therapeutic injection with pharmaceutical or autologous agents (steroids, botulinum toxin, hyaluronic acid, and platelet-rich plasma). Demographic data included age, gender, history of smoking, reflux disease, allergy, voice diagnosis, body mass index (BMI), neck, and waist circumference. After the procedure, all patients were asked to fill out the IOWA satisfaction with anesthesia scale.

Forty-three males and 39 females, mean age 50.56 ± 16.60 years, were included in this study. These were divided into three subgroups: those with a BMI < 25 Kg/m² (n = 27), those with a BMI ranging between 25-29 Kg/m² (n = 33), and those with a BMI ≥ 30 Kg/m² (n = 22). All subgroups were matched by age, gender, history of smoking, and history of reflux. There was a statistically significant difference in the mean IOWA scores between the three subgroups (P = 0.009). Regression analysis accounting for various variables showed a mild significant negative association between neck circumference and IOWA satisfaction score. Subgroup analysis based on type of procedure showed a mild but significant negative association between IOWA score and BMI in those who underwent office-based laser therapy.

The results of this investigation showed a statistically significant difference in the mean IOWA score across subgroups of patients belonging to different BMI categories undergoing OBLP via the transnasal approach. There was also a significant, mild negative correlation between BMI and IOWA score in the subgroup who had laser therapy. These results might be useful for patient selection and counseling before OBLP.