title: In-office cup biopsy and laryngeal cytology versus operating room biopsy for the diagnosis of pharyngolaryngeal tumors: Efficacy and cost-effectiveness.
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.
  
  
  CONCLUSIONS
  In-office biopsy is a more affordable technique that enables histologic diagnosis of pharyngolaryngeal lesions in a large percentage of patients.
authors.affiliation: Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.|Facultad de Medicina, Universidad San Sebastián, Puerto Montt, Chile.
authors.forename: Felipe
authors.initials: F
authors.lastname: Castillo Farías
authors.affiliation: Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cobeta
authors.affiliation: Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
authors.forename: Rosalia
authors.initials: R
authors.lastname: Souviron
authors.affiliation: Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Barberá
authors.affiliation: Otolaryngology - Head and Neck Surgery Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Mora
authors.affiliation: Pathology Department, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Benito
authors.affiliation: CIBERESP, IRYCIS Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Royuela
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D003362:Cost-Benefit Analysis; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology*; D007830:Larynx / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D010610:Pharyngeal Neoplasms / Q000473:pathology*; D010614:Pharynx / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
keywords: ambulatory surgical procedures; biopsy; cost-benefit analysis; cytology; head and neck neoplasms