Felipe Castillo Farías1,2, Ignacio Cobeta1, Rosalia Souviron1, Rafael Barberá1, Elena Mora1, Amparo Benito3, Ana Royuela4. 1. Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain. 2. Facultad de Medicina, Universidad San Sebastián, Puerto Montt, Chile. 3. Pathology Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain. 4. CIBERESP, IRYCIS Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
Abstract
BACKGROUND: In-office biopsy is an effective technique to diagnose the nature of pharyngolaryngeal lesions. METHODS: We selected patients with pharyngolaryngeal lesions suspicious for malignancy. For in-office biopsy procedures, laryngeal cytology and direct laryngoscopy biopsy were performed, and diagnostic parameters and costs were estimated. RESULTS: Eighty-eight patients were selected for this study. For laryngeal cytology, sensitivity was 70.3% (95% confidence interval [CI] = 59.9% to 80.7%), specificity 100% with a positive predictive value of 100% and a negative predictive value of 50% (95% CI = 35.2% to 64.8%). In-office biopsy sensitivity was 81% (95% CI = 72.6% to 89.3%), specificity 100% with a positive predictive value of 100% and a negative predictive value of 20% (95% CI = 2.5% to 37.5%). At our hospital, the use of in-office biopsies as a first approach for diagnosis saves $50,140.80 U.S. per annum. CONCLUSION: In-office biopsy is a more affordable technique that enables histologic diagnosis of pharyngolaryngeal lesions in a large percentage of patients.
BACKGROUND: In-office biopsy is an effective technique to diagnose the nature of pharyngolaryngeal lesions. METHODS: We selected patients with pharyngolaryngeal lesions suspicious for malignancy. For in-office biopsy procedures, laryngeal cytology and direct laryngoscopy biopsy were performed, and diagnostic parameters and costs were estimated. RESULTS: Eighty-eight patients were selected for this study. For laryngeal cytology, sensitivity was 70.3% (95% confidence interval [CI] = 59.9% to 80.7%), specificity 100% with a positive predictive value of 100% and a negative predictive value of 50% (95% CI = 35.2% to 64.8%). In-office biopsy sensitivity was 81% (95% CI = 72.6% to 89.3%), specificity 100% with a positive predictive value of 100% and a negative predictive value of 20% (95% CI = 2.5% to 37.5%). At our hospital, the use of in-office biopsies as a first approach for diagnosis saves $50,140.80 U.S. per annum. CONCLUSION: In-office biopsy is a more affordable technique that enables histologic diagnosis of pharyngolaryngeal lesions in a large percentage of patients.
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: 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