Impact of Upper Airway Narrowing on Patient Tolerance in Office-Based Blue Laser Surgery.

Objective: The purpose of this study was to evaluate the impact of upper airway narrowing on patient tolerance in office-based laser surgery.

Study design: Retrospective chart review.

Methods: All patients who underwent office-based blue laser surgery for benign and premalignant laryngeal lesions between November 2021 and September 2024 were reviewed. The Iowa Satisfaction with Anesthesia Scale questionnaire and the Visual analogue scale score for discomfort were used. Demographic data included age, gender, smoking, Body mass Index, comorbidities, and etiology of dysphonia. Four anatomical sites of the upper airway were evaluated for the presence of narrowing: the nose, nasopharynx, oro-/hypopharynx, and larynx.

Results: A total of 89 patients were included. The most common site of upper airway narrowing was the nose in 74.1% of the cases. This was followed by the nasopharynx and oro-hypopharynx in 23.5% and 20.2% of the cases, respectively. Only 11 patients had laryngeal narrowing with the most common cause being prolapse of the epiglottis. The mean IOWA score of the study group was 1.5 ± 1.1. There was no significant difference in the mean IOWA score between those with or without laryngeal narrowing. The mean VAS score was 2.98 ± 2.47. There was also no significant difference in the mean VAS discomfort score in patients with or without upper airway narrowing, except in those with oro-/hypopharyngeal narrowing (P = 0.011).

Conclusion: Upper airway narrowing had a nonsignificant impact on patient tolerance and discomfort. Nevertheless, patients with narrowing of the upper airway require diligent handling of the endoscope to reduce any potential discomfort.