Summary
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.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of VoiceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- The history of laryngology: a centennial celebration.Otolaryngol Head Neck Surg. 1996; 114: 345-354
- Video rigid laryngeal endoscopy compared to laryngeal mirror examination: an assessment of patient comfort and clinical visualization.Laryngoscope. 2009; 119: 269-271
- Diagnostic laryngeal endoscopy.Otolaryngol Clin North Am. 2000; 33: 751-757
- Gleeson M Scott-Brown's Otorhinolaryngology: Head and Neck Surgery 7 ed: 3 volume set. 7 edition. Jaypee medical, London2008: 3900
- Development of procedures and techniques for the office.Otolaryngol Clin North Am. 2013; 46: 1-11
- New laryngoscopic technique by use of fiber optics.J Acoust Soc Am. 1968; 43: 168-169
- The use of topical nasal anaesthesia before flexible nasendoscopy: a double-blind, randomized controlled trial comparing cophenylcaine with placebo.Clin Otolaryngol Allied Sci. 2002; 27: 485-488
- Is local anaesthesia actually beneficial in flexible fibreoptic nasendoscopy?.Clin Otolaryngol Allied Sci. 1998; 23: 259-262
- Cophenylcaine spray vs. placebo in flexible nasendoscopy: a prospective double-blind randomised controlled trial.Int J Clin Pract. 2005; 59: 130-133
- A prospective, double-blind, randomized study on the use of a topical anesthetic, vasoconstrictor, and placebo during transnasal flexible fiberoptic endoscopy.J Speech Lang Hear Res. 1997; 40: 1352-1357
- The efficacy of topical anaesthesia in flexible nasendoscopy: a double-blind randomised controlled trial.Clin Otolaryngol Allied Sci. 2001; 26: 25-28
- The use of lubrication in flexible fibreoptic nasendoscopy: a randomized controlled trial.Clin Otolaryngol. 2005; 30: 353-356
Article info
Publication history
Published online: October 19, 2020
Accepted:
October 9,
2020
Footnotes
The study was part funded by Fluid Research Grant (institutional).
Identification
Copyright
© 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.