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
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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.
