In-office biopsy of upper airway lesions: safety, tolerance, and effect on time to treatment.
OBJECTIVE
Definitive tissue diagnosis for lesions warranting biopsy is shifting from the operating room to the office. Safety, tolerance, factors related to successful biopsy, and time to treatment are not well-defined.


METHODS
Retrospective review of 116 patients undergoing in-office biopsy of oropharynx, larynx, or hypopharynx were included. Logistic regression determined if demographics, site, T-stage, or approach (transoral/transnasal) were related to success. Time to definitive treatment was also analyzed.


RESULTS
Ninety-two transnasal and 24 transoral biopsies were performed on 73 laryngeal, 35 oropharyngeal, and 8 hypopharyngeal lesions. Of those, 97 of 116 diagnoses were made in-office. There were no complications; two patients did not tolerate the procedure. Success was not related to age (P = 0.374), site (P = 0.527), T-stage (P = 0.587), or approach (P = 0.566). Time to treatment was 24.2 ± 13.9 days with successful office biopsy and 48.8 ± 49.4 days without.


CONCLUSIONS
High procedural completion rate was observed across patients, sites, and approaches. All patients should be considered for in-office biopsy, a more time- and cost-effective option leading to earlier treatment.
University of Wisconsin-Madison School of Medicine and Public Health, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Madison, Wisconsin, U.S.A.
Dylan
D
Lippert
Matthew R
MR
Hoffman
Phat
P
Dang
Timothy M
TM
McCulloch
Gregory K
GK
Hartig
Seth H
SH
Dailey
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000379:methods*; D000704:Analysis of Variance; D001707:Biopsy, Needle / Q000191:economics / Q000379:methods*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D017046:Cost Savings; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007828:Laryngoscopy / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D061646:Operative Time; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery; D061214:Patient Safety; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity
Office biopsy; head and neck cancer; office procedure; upper airway lesions