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Keywords:

  • Laryngology;
  • laryngeal surgery;
  • office-based;
  • procedures;
  • surgery;
  • airway examination;
  • patient safety;
  • bronchscopy;
  • laryngoscopy;
  • airway stenosis;
  • Level of Evidence: 4

Abstract

Objectives/Hypothesis:

Unsedated transnasal tracheoscopy (TNT) has emerged as a technique in otolaryngology–head and neck surgery for an awake airway examination in the office setting. This study investigates the safety, procedural success rate, indications, and findings of TNTs performed over a 3-year period at an academic medical center.

Study Design:

Retrospective chart review.

Methods:

After institutional review board approval, billing records were reviewed for patients who underwent TNT from 2007–2009 in the University of Wisconsin–Madison Department of Otolaryngology–Head and Neck Surgery. Hospital charts for these patients were obtained, and data regarding patient demographics, complications, procedural success rate, indications, and findings were recorded.

Results:

Sixty-eight TNTs were performed on 44 patients over the last 3 years (25 males, 19 females; age range, 16–91 years). No complications were noted. Ninety-one percent of procedures were able to be completed. Indications for TNT were to: 1) detect airway stenosis or pathology, 2) evaluate the larynx and trachea prior to airway surgery, 3) monitor postoperative results of airway interventions, and 4) evaluate the airway prior to tracheotomy tube decannulation.

Conclusions:

TNT is a safe procedure that can be performed on the unsedated patient using only topical anesthesia and is an attractive alternative to rigid bronchoscopy. The procedural success rate was high, indicating good patient tolerance. The indications for TNT, including its use as a tool for surgical planning, have become better defined. TNT has become a standard tool in the management of patients with airway pathology in our practices.