Office-based direct fiberoptic laryngoscopic surgery

The development of flexible fiberoptic endoscopes, compact video systems, flexible laser fibers and instruments, and short-acting anesthetics and sedatives allow laryngeal surgery in an office setting. In patients who have underlying medical problems, anatomical variations that limit exposure of the larynx with rigid instrumentation, a need for repetitive procedures, or patient choice not to have a general anesthetic, the office-based fiberoptic endoscopic laryngeal surgery may be the procedure of choice. These procedures are dependent on excellent local anesthesia. The techniques are described. The advantages, indication, contraindications, and complications are discussed. Flexible fiberoptic laryngeal surgery offers a new avenue to the modern laryngologist, incorporating new technology in the office setting.