title: The Safety of Antithrombotic Therapy During In-office Laryngeal Procedures-A Preliminary Study.
abstract: BACKGROUND
  In-office laryngeal procedures present an alternative to the risks and costs associated with general anesthesia. However, the inherent control afforded by the operative theater is decreased potentially increasing the risk of complications. Many patients undergoing these procedures have traditional surgical risk factors, such as antithrombotic (AT) medical therapy. We sought to quantify complication rates for in-office procedures as a function of AT therapy.
  
  
  METHODS
  A retrospective review of 127 diverse, in-office laryngeal procedures was performed and patients were then stratified based on AT medication status and type of procedure. The primary dependent variables were intraoperative and postoperative complications. Additionally, in those patients undergoing procedures with the goal of voice improvement, Voice Handicap Index (VHI)-10 scores were used to quantify the success of the procedure as a function of AT therapy.
  
  
  RESULTS
  Of the 127 procedures, 27 procedures (21.2%) involved patients on some form of AT agent that was not ceased for the procedure. Across all patients, no intraoperative complications were encountered, irrespective of therapeutic status. Three postoperative complications were noted; all in patients not on AT therapy. A statistically significant improvement in VHI-10 scores was noted across all patients, irrespective of AT status.
  
  
  CONCLUSIONS
  AT medications do not appear to increase the risk of complications associated with in-office laryngeal procedures. Furthermore, AT therapy seemed to have no negative impact on the voice outcomes of patients undergoing procedures for voice improvement.
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Fritz
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York.
authors.forename: Robert
authors.initials: R
authors.lastname: Peng
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York.
authors.forename: Hayley
authors.initials: H
authors.lastname: Born
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Cerrati
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York.
authors.forename: Avanti
authors.initials: A
authors.lastname: Verma
authors.affiliation: Department of Population Health and Biostatistics, New York University School of Medicine, New York, New York.
authors.forename: Binhuan
authors.initials: B
authors.lastname: Wang
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York. Electronic address: ryan.branski@nyumc.org.
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Branski
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York.
authors.forename: Milan R
authors.initials: MR
authors.lastname: Amin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D011183:Postoperative Complications / Q000139:chemically induced*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014832:Voice Disorders / Q000628:therapy*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents
keywords: Anticoagulation; Antiplatelet; Antithrombotic; KTP laser; Larynx; Voice