Transnasal Flexible Laryngoscopy Using Different Topical Preparations and Methods of Application-A Randomized Study.

Autor: Joy AK; Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India; Christian Fellowship Hospital, Oddanchatram, Tamil Nadu, India., Philip A; Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India., Mathews SS; Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India. Electronic address: sumasusanm@yahoo.co.in., Albert RRA; Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India.
Jazyk: angličtina
Zdroj: Journal of voice : official journal of the Voice Foundation [J Voice] 2022 Nov; Vol. 36 (6), pp. 847-852. Date of Electronic Publication: 2020 Oct 20.
DOI: 10.1016/j.jvoice.2020.10.009
Abstrakt: Background: The field of laryngology has grown exponentially since the advent of the transnasal flexible laryngoscopy. Flexible laryngoscopy when performed skillfully using the proper technique, facilitates a good view of the hidden areas of the larynx.
Objective: To compare the effectiveness of the topical agents in providing a more comfortable experience for the patient, allowing the practitioner to advance the endoscope with less friction, pain and discomfort for the patient using 10% lidocaine spray, 2% lidocaine gel, 4% lidocaine with xylometazoline (1:1) soaked pledgets, or aqueous gel.
Materials and Methods: A prospective randomized single-blinded clinical trial was conducted in a tertiary care teaching hospital in South India where 376 patients were recruited and allocated into four groups based on the topical preparation used. Following endoscopy, each subject filled a questionnaire grading their experience on a visual analogue scale. The clinician also then answered a questionnaire on aspects of the endoscopy performed.
Results: The pain score and the ease of performing the procedure among the different groups were comparable. Those in the 10% lidocaine arm experienced significant burning sensation (P = 0.0001). The other variables such as throat pain (P = 0.783), gag reflex (P = 0.318), unpleasant taste (P = 0.092), globus (P = 0.190), swallowing difficulty after the procedure (P = 0.273), difficulty in breathing (P = 0.744) and willingness to have a repeat procedure (P = 0.883) were also comparable.
Conclusion: Aqueous gel can be used topically during a flexible nasopharyngolaryngoscopy instead of an anesthetic agent alone or one combined with a nasal decongestant.
(Copyright © 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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