OBJECTIVE: To compare the diagnostic yield, safety, and cost of biopsies of laryngopharyngeal tumor performed in an office setting with those performed in the operating room (OR) under general anesthesia. STUDY DESIGN: This was a retrospective review of patients' records at Boston Medical Center from 2006 to 2008. METHODS: In-office biopsies were performed using flexible digital videolaryngoscopy with cup forcep biopsies taken via the working channel in patients in whom cancer was strongly suspected. Patients whose in-office biopsies were nondiagnostic or suspected to be falsely negative were taken to the OR for biopsy under general anesthesia and served as the control group. RESULTS: Twelve patients fit the selection criteria and had in-office biopsies attempted. One patient could not tolerate the in-office biopsy. Seven of the 11 in-office biopsies performed were diagnostic for squamous cell carcinoma. The average cost (facility and professional otolaryngology charges) for an in-office biopsy was $2053.91. Five of these patients required further biopsy in the OR at an average cost (charges for surgeon, OR, anesthesia, and recovery room) of $9024.47. There were no significant complications reported for any of the procedures. CONCLUSIONS: In patients with strongly suspected laryngopharyngeal cancer, in-office cup forcep biopsies were 64% diagnostic. When compared with the OR, in-office cup biopsies of laryngopharyngeal tumor are safe and considerably more cost-effective. Although 36% of patients required operative biopsies, the cost would have been considerably higher in this cohort if all patients had gone to the OR for biopsies.
OBJECTIVE: To compare the diagnostic yield, safety, and cost of biopsies of laryngopharyngeal tumor performed in an office setting with those performed in the operating room (OR) under general anesthesia. STUDY DESIGN: This was a retrospective review of patients' records at Boston Medical Center from 2006 to 2008. METHODS: In-office biopsies were performed using flexible digital videolaryngoscopy with cup forcep biopsies taken via the working channel in patients in whom cancer was strongly suspected. Patients whose in-office biopsies were nondiagnostic or suspected to be falsely negative were taken to the OR for biopsy under general anesthesia and served as the control group. RESULTS: Twelve patients fit the selection criteria and had in-office biopsies attempted. One patient could not tolerate the in-office biopsy. Seven of the 11 in-office biopsies performed were diagnostic for squamous cell carcinoma. The average cost (facility and professional otolaryngology charges) for an in-office biopsy was $2053.91. Five of these patients required further biopsy in the OR at an average cost (charges for surgeon, OR, anesthesia, and recovery room) of $9024.47. There were no significant complications reported for any of the procedures. CONCLUSIONS: In patients with strongly suspected laryngopharyngeal cancer, in-office cup forcep biopsies were 64% diagnostic. When compared with the OR, in-office cup biopsies of laryngopharyngeal tumor are safe and considerably more cost-effective. Although 36% of patients required operative biopsies, the cost would have been considerably higher in this cohort if all patients had gone to the OR for biopsies.
Authors: David J Wellenstein; Joey K de Witt; Henrieke W Schutte; Jimmie Honings; Frank J A van den Hoogen; Henri A M Marres; Robert P Takes; Guido B van den Broek Journal: Eur Arch Otorhinolaryngol Date: 2017-06-21 Impact factor: 2.503
Authors: Francisco Lee; Kristine A Smith; Shamir Chandarana; T Wayne Matthews; J Douglas Bosch; Steven C Nakoneshny; Joseph C Dort Journal: J Otolaryngol Head Neck Surg Date: 2018-05-09
Authors: Henrieke W Schutte; Guido B van den Broek; Stefan C A Steens; Rosella P M G Hermens; Jimmie Honings; Henri A M Marres; Matthias A W Merkx; Willem L J Weijs; Anne I J Arens; Adriana C H van Engen-van Grunsven; Carla M L van Herpen; Johannes H A M Kaanders; Frank J A van den Hoogen; Robert P Takes Journal: Cancer Date: 2020-07-07 Impact factor: 6.860
Authors: David J Wellenstein; Jimmie Honings; Anouk S Schimberg; Henrieke W Schutte; Jasmijn M Herruer; Frank J A van den Hoogen; Robert P Takes; Guido B van den Broek Journal: Laryngoscope Date: 2019-09-09 Impact factor: 3.325