Twenty-five laryngologists from the British Laryngological Association, European Laryngological Society and Union of European Phoniatricians used a modified Delphi process, with 80% agreement required, to set out indications, contraindications and periprocedural care for office-based laryngology. They approved 60 statements.
Core indications included vocal fold polyps, Reinke's oedema, varices, leukoplakia, biopsies, granulomas, recurrent respiratory papillomatosis and selected vocal fold augmentation. Statements also cover preprocedural assessment, technique, postprocedural care, success criteria, and environmental and economic outcomes.
Office procedures under local anaesthesia avoid general anaesthesia and theatre time, which matters where theatre lists are long. The consensus gives units a shared reference for which patients to select.
- Consider office-based treatment for polyps, Reinke's oedema, granulomas and papillomatosis
- Office biopsy of leukoplakia can shorten time to diagnosis
- Select patients who can tolerate transnasal endoscopy and topical anaesthesia
- Define success criteria and follow-up in advance
- Refer to the consensus when building a local office laryngology protocol
Why it matters
It gives a standard for moving suitable laryngeal procedures out of theatre.
Don't overread it
This is expert consensus, not comparative outcome evidence.
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