European Practice Consensus on Office-Based Laryngology

To establish European consensus on indications, contraindications, and periprocedural management of office-based laryngology (OBL) procedures.

Twenty-five laryngologists from the British Laryngological Association, European Laryngological Society, and Union of European Phoniatricians were included in a modified Delphi process to establish statements about indications, contraindications, and periprocedural clinical considerations for OBL procedures. The Delphi was organized through a maximum of four anonymous voting rounds, each separated by revision of unaccepted statements. Consensus required ≥ 80% agreement (agree/strongly agree); statements with 60%-79.9% agreement were revised for re-voting. GRADE system was used for validated statement assessment.

Sixty statements were approved across two voting rounds. The first round validated 49 statements, and 11 statements were approved after revision (expert intraclass correlation coefficient: 0.798 (95% CI: 0.645-0.911)). Statements covered preprocedural considerations (n = 6), indications and contraindications (n = 11), technical considerations (n = 17), vocal fold augmentation (n = 7), postprocedural care and success criteria (n = 14), and environmental, economic, and societal outcomes (n = 5). Primary indications included polyps, Reinke's edema, varices, leukoplakia, biopsies, granulomas, recurrent respiratory papillomatosis, and selected indications for vocal fold augmentation.

This European consensus provides a unified consensus on indications, contraindications, and perioperative management of OBL procedures.

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