Nasolaryngoscopy in a Family Medicine Clinic: Indications, Findings, and Economics

T. Wilkins, R. A. Gillies, A. Getz, D. Zimmerman, L. Kang
2010 Journal of the American Board of Family Medicine  
word count: 197 Manuscript word count: 2380 Number of references: 12 Number of tables: 6 Number of figures: 0 2 ABSTRACT Background: Nasopharyngeal complaints are common in primary care. Patients with these complaints are often referred for nasolaryngoscopy evaluation to exclude serious conditions, e.g., laryngeal cancer. Methods: This study is a retrospective case series in which 276 charts were reviewed for adult outpatients who were referred for nasolaryngoscopy. We examined patient
more » ... ed patient demographics, procedure indications and findings, complications, changes in clinical management. Results: Nasolaryngoscopy was completed in 273 (98.9%) patients (mean age, 51.3 +/-14.6, 71.4% women). The most common indications for nasolaryngoscopy were hoarseness (51.3%), globus sensation (32.0%), and chronic cough (17.1%), and the most common findings included laryngopharyngeal reflux (LPR) (42.5%), chronic rhinitis (32.2%), and vocal cord lesion (13.2%). Laryngeal cancer was diagnosed in 3 patients (1.1%) and was significantly associated with a prior history of smoking (p=0.03). No major complications occurred. Conclusions: We found that nasolaryngoscopy is a safe procedure in primary care with no major complications in our series. Patients who have ever smoked and complain of hoarseness are at higher risk for laryngeal cancer. An alarming 1% of patients in our series were diagnosed with laryngeal cancer. This is the first study to define the rates of LPR, vocal
doi:10.3122/jabfm.2010.05.090186 pmid:20823353 fatcat:zjkmiymiibg2jammeelj3xgxxy