COMPARATIVE STUDY OF IN-OFFICE FIBER-OPTIC BRONCHOSCOPY AND MICROLARYNGOSCOPY FOR LARYNGEAL MASS DIAGNOSIS

Abstract

Background: Microlaryngoscopy (MLscopy) and direct laryngoscopy have been the traditional choice for diagnosing laryngeal masses among ENT surgeons, whereas transnasal fiber-optic bronchoscopy (FOB) is preferred by pulmonologists for various in-office endobronchial pathologies. The comparative accuracy and cost-effectiveness of these methods in diagnosing laryngeal masses have remained uncertain. Objective: The study aims to compare the histopathologic accuracy, diagnostic effectiveness, and cost-effectiveness of in-office FOB with MLscopy and direct laryngoscopy in patients with laryngeal masses. Methods: This study involved 70 patients with suspicious laryngeal or vocal cord masses. Patients with significant comorbidities underwent FOB, while others underwent MLscopy. FOB was performed under local anesthesia in an office setting, and MLscopy was conducted under general anesthesia with required hospitalization. The study compared the histopathologic accuracy, duration of hospital stay, and costs between the two methods. Results: FOB proved to be less time-consuming and more cost-effective, with patients spending about three hours for the procedure at a cost of ₹4600, as compared to those undergoing MLscopy, who were hospitalized for at least 12 hours at a cost of ₹22000. While both methods showed high histopathologic accuracy, FOB was slightly less accurate than MLscopy. Conclusion: Both in-office FOB and MLscopy are effective in diagnosing laryngeal masses. However, FOB offers a more cost-effective and efficient alternative, particularly suitable for patients with comorbidities or in settings where reduced hospital stay and cost are priorities. The study underscores the importance of adopting patient-friendly, cost-effective diagnostic procedures in healthcare, especially in resource-constrained settings like India. Future recommendations include broader studies to further validate these findings and potentially integrate more advanced technologies for enhanced accuracy and patient comfort.