Reliability of office-based narrow-band imaging-guided flexible laryngoscopic tissue samplings.

OBJECTIVES/HYPOTHESIS Direct suspension laryngoscopic biopsy performed under general anesthesia is the conventional management for obtaining pathological diagnosis for neoplasms of the larynx, oropharynx, and hypopharynx. Since the development of distal chip laryngoscopy and digital imaging systems, transnasal flexible laryngoscopy tissue sampling has gained popularity as an office-based procedure. Additional assessment with narrow-band imaging (NBI) can help to increase the diagnostic yield. The aim of the study was to evaluate the accuracy, sensitivity, and specificity of a novel diagnostic tool: office-based NBI (OB-NBI) flexible laryngoscopic tissue sampling. STUDY DESIGN Retrospective chart review performed in a tertiary referral medical center in Taiwan. METHODS From January 2010 to February 2013, 90 consecutive patients received OB-NBI biopsies. The accuracies of the OB-NBI biopsies were compared among locations, tumor sizes, head and neck cancer histories, and other factors. RESULTS All patients had completed the procedure without life-threatening complications. The overall sensitivity and specificity were 97.2% and 100%, respectively, with a diagnostic accuracy of 98.9%. Accuracy was not affected by tumor size, location, learning curves, or previous head and neck cancer history. CONCLUSIONS We present an integrated technique that merges the safety and versatility of flexible laryngoscopy with the diagnostic power of NBI to produce a promising method of high accuracy and minimal morbidity. LEVEL OF EVIDENCE 4 Laryngoscope, 126:2764-2769, 2016.