title: Morbidity and patient perception of flexible laryngoscopy.
abstract: OBJECTIVE
  The recently published Clinical Practice Guideline: Hoarseness (Dysphonia) revealed major deficits in the literature regarding relatively routine clinical decision-making. One of the more controversial points in the Guideline regarded the utility and timing of laryngeal visualization via flexible laryngoscopy, potentially because of sparse literature regarding the risks and potential morbidity. We sought to prospectively address this issue in order to optimize evaluation protocols.
  
  
  METHODS
  Two-hundred fifty consecutive patients with a variety of complaints completed a survey after undergoing flexible laryngoscopy. The survey queried 1) demographics; 2) discomfort of pretreatment anesthesia and scope placement in the nose and pharynx; 3) fear of future examinations; and 4) patient perception and past experience. Concurrently, the laryngoscopist reported the complications and anatomic variations encountered.
  
  
  RESULTS
  The discomfort and pain ratings from both the anesthetic spray and the scope placement were low. No statistically significant differences were observed with regard to sex; however, women reported greater fear associated with examinations (p = 0.0001). Anatomic abnormalities were observed in 14.4% of patients, and these patients reported greater discomfort, pain, and fear regarding the examination. No adverse events were observed.
  
  
  CONCLUSIONS
  Flexible laryngoscopy was well tolerated, with little to no risk. The presence of nasal anatomic abnormalities predicted increased discomfort.
authors.affiliation: New York University Voice Center, Department of Otolaryngology, New York University School of Medicine, New York, New York 10016, USA.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Paul
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rafii
authors.forename: Stratos
authors.initials: S
authors.lastname: Achlatis
authors.forename: Milan R
authors.initials: MR
authors.lastname: Amin
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Branski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D015331:Cohort Studies; D005239:Fear; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000523:psychology*; D007828:Laryngoscopy / Q000009:adverse effects* / Q000295:instrumentation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D057240:Patient Preference / Q000523:psychology*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local