INDIRECT LARYNX AND PHARYNX SURGERY - A REPLACEMENT FOR DIRECT LARYNGOSCOPY

During a 2-year period, 192 indirect surgeries on the laryngopharynx w ere performed in an outpatient videoendoscopy laboratory under topical anesthesia with or without intravenous sedation. These procedures inc luded cancer staging and biopsy; vocal fold injections of Teflon, Gelf oam, botulinum toxin, or steroids; glottic web lysis; and granuloma re moval. The techniques used to perform these procedures are elucidated. Careful chart review of these patients shows that indirect surgery wa s pet-formed successfully ill 96% of cases. Intravenous conscious seda tion was utilized in 39% of patients, No significant complications wer e encountered. By avoiding the need for an operating room, hospitaliza tion, or general anesthesia, this technique was clearly as safe or saf er more convenient for surgeon and patient, and more cost-effective th an the same procedure would have been via the traditional direct laryn goscopy. As the authors have already done in their practices, the indi rect method should therefore be reinstated as the preferred approach t o the clinical circumstances described here.