An alternative technique for nasal biopsy.
OBJECTIVE
The objective was to investigate the effectiveness of co-phenylcaine as a topical anesthetic agent for nasal mucosal biopsy.


METHODS
A prospective study.


METHODS
Nasal mucosal biopsy specimens were taken from a site just anterior to the inferior turbinate following topical anesthesia with co-phenylcaine. All volunteers graded pain according to standard visual analogue scale (0-10) (VAS) scoring, and all were followed up after 24 hours for any epistaxis.


RESULTS
Ninety nasal biopsy specimens were removed from 41 patients in all. Eight-two percent did not report any discomfort following this procedure (VAS score, 0). Ten patients reported mild discomfort (VAS scores ranging between, 1 and 3) and only six reported pain (VAS scores ranging from 5 to 7). However, five of these patients agreed to further biopsy and documented no discomfort during the repeat procedure. Only one patient required immediate intervention for hemorrhage after the procedure. In cases in which bleeding occurred (seven patients) it was documented within the first 6 hours, was minimal in content, and was controlled with local pressure. No systemic side effects were experienced.


CONCLUSIONS
Co-phenylcaine is a suitable topical anesthetic agent for nasal mucosal biopsy. Removal of nasal tissue from a site anterior to the inferior turbinate can be performed under direct vision and provides sufficient tissue for histological assessment.
Thornton
M A
MA
Department of Otolaryngology-Head and Neck Surgery, RCSI Smurfit Education and Research Centre, Beaumont Hospital, Dublin, Ireland. mthornton@rcsi.ie
Walshe
P
P
Costello
R W
RW
McConn-Walsh
R
R
Walsh
M A
MA
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001706:Biopsy / Q000379:methods*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology*; D010147:Pain Measurement; D010656:Phenylephrine / Q000008:administration & dosage*; D011446:Prospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D000779:Anesthetics, Local; D004338:Drug Combinations; C487939:Phaedpharm; D014662:Vasoconstrictor Agents; D010656:Phenylephrine; D008012:Lidocaine