Performance of In-Office Laryngeal Procedures Using Single-Use Endoscopes

In-office laryngeal procedures have expanded in recent years due to several factors, including advances in equipment and efforts to reduce health care costs. Single use endoscopes have been adopted primarily in the inpatient setting and offer several advantages over reusable equipment, including lower capital investment and the elimination of costs of reprocessing and repairs. This study investigates the performance of single use endoscopes for in-office laryngeal procedures.

A retrospective review at a single institution of patients who underwent in-office laryngeal procedures using single-use channeled endoscopes. Data including demographics, pathology, equipment, treatment outcomes, and adverse events were collected retrospectively.

Twenty-four patients who underwent in-office blue light laser or biopsy procedures between 10/2023 and 4/2024 were included. Among seven completed biopsies, six specimens (85.7%) were adequate for diagnosis; there were no complications. Twenty-one laser procedures were performed, with 20 successfully completed. One patient had poor tolerance requiring early termination. There were 2 minor post-procedural adverse effects (11.1%), including dyspnea and headache. Pathologies treated included laryngeal papilloma (44.4%), vocal fold polyps (27.8%), dysplasia (16.7%), redundant arytenoid/postcricoid mucosa (11.1%), vascular ectasias (16.7%), and hyperkeratosis (5.56%). Laser output ranged from 9 to 289 Joules. Ten patients had resolution of lesion(s) (55.6%), 4 had reduction in disease burden (22.2%), 2 had stable disease (11.1%), and 1 had disease progression (5.56%). One patient was lost to follow-up.

In-office laryngeal procedures using single-use endoscopes are feasible, with acceptable outcomes which align with standard of care. This treatment modality may improve access to centers where reusable equipment is not available, and may improve efficiency in the treatment of laryngeal disorders.