Application of flexible endoscopy-based biopsy in the diagnosis of tumour pathologies in otorhinolaryngology

Abstract

Introduction and objectives: Interventional endoscopy allows us to act on the pathology of the patient with minimal discomfort, low costs and high efficiency. We assessed the validity of flexible endoscopic biopsies in our hospital, in lesions suspected of malignancy in the rhino-pharyngo-laryngeal space.

Subjects and methods: Retrospective study of patients with a pathology suspected of malignancy assessed between 2006-2016 in our centre. We evaluated the effectiveness, the tolerance and the number of complications. We calculated the cost reduction in comparison with direct laryngoscopy in the operating room. We compared our sample with others of similar characteristics described in the literature.

Results: Thirty patients were studied with a flexible endoscopic biopsy during that period. Nineteen patients obtained positive results which allowed them to start treatment for their pathology. Seven cases had no evidence of malignancy and required another biopsy under general anaesthesia, which confirmed the carcinoma diagnosis. Two samples ruled out malignancy which was confirmed by laryngeal microsurgery. One case showed inflammation and the lesion was cured after antibiotherapy. It was impossible to collect the sample in one case. Thus, we obtained sensitivity levels of 73% with a specificity of 100%. There were no complications. The cost reduction in our sample was above 80%.

Conclusions: Flexible endoscopic biopsy has advantages over direct laryngoscopy that are relevant in the diagnosis of oncological pathology in otorhinolaryngology.

Keywords: Análisis coste beneficio; Biopsia flexible; Cost-benefit analysis; Cáncer faríngeo; Cáncer laríngeo; Disfagia; Disfonía; Dysphagia; Dysphonia; Flexible biopsy; Flexible laryngoscope; In-office procedure; Laringoscopia flexible; Laryngeal cancer; Laryngeal mass; Masa laríngea; Outpatient surgical procedures; Pharyngeal cancer; Procedimiento en consulta; Procedimientos quirúrgicos ambulatorios.