title: Nasolaryngoscopy in a family medicine clinic: indications, findings, and economics.
abstract: BACKGROUND
  Nasopharyngeal complaints are common among patients who present to primary care. Patients with these complaints are often referred for nasolaryngoscopy evaluation to exclude serious conditions such as laryngeal cancer.
  
  
  METHODS
  This study is a retrospective case series in which 276 charts of adult outpatients who were referred for nasolaryngoscopy were reviewed. We examined patient demographics, procedure indications and findings, complications, and changes in clinical management.
  
  
  RESULTS
  Nasolaryngoscopy was completed in 273 (98.9%) patients (mean age, 51.3 +/- 14.6 years; 71.4% were women). The most common indications for nasolaryngoscopy were hoarseness (51.3%), globus sensation (32.0%), and chronic cough (17.1%); the most common findings included laryngopharyngeal reflux (42.5%), chronic rhinitis (32.2%), and vocal cord lesions (13.2%). Three patients (1.1%) were diagnosed with laryngeal cancer and this diagnosis was significantly associated with a history of smoking (P = .03). No major complications occurred.
  
  
  CONCLUSIONS
  We found that nasolaryngoscopy was a safe procedure in the primary care setting, and no major complications occurred in our series. Patients who have ever smoked and complain of hoarseness are at higher risk for laryngeal cancer. An alarming 1% of patients in our series were diagnosed with laryngeal cancer. This is the first study to define the rates of laryngopharyngeal reflux, vocal cord lesions, and laryngeal cancer among primary care patients.
authors.affiliation: Department of Family Medicine, Medical College of Georgia, Augusta, GA, USA. twilkins@mcg.edu
authors.forename: Thad
authors.initials: T
authors.lastname: Wilkins
authors.forename: Ralph A
authors.initials: RA
authors.lastname: Gillies
authors.forename: April
authors.initials: A
authors.lastname: Getz
authors.forename: Dave
authors.initials: D
authors.lastname: Zimmerman
authors.forename: Larry
authors.initials: L
authors.lastname: Kang
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D005194:Family Practice / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D007828:Laryngoscopy / Q000191:economics / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009302:Nasopharyngeal Diseases / Q000175:diagnosis*; D012189:Retrospective Studies; D015144:Southeastern United States; D014504:Urban Health