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Lung India Official publication of Indian Chest Society  
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Year : 2019  |  Volume : 36  |  Issue : 3  |  Page : 199-201

Flexible bronchoscopy-guided vocal cord biopsy under conscious sedation: An option to surgical biopsy in special situations

1 Department of Pulmonary, Critical Care and Sleep Medicine, Apollo Hospitals, Bengaluru, Karnataka, India
2 Department of Ear, Nose and Throat, Columbia Asia Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Ravindra M Mehta
112 Classic Orchards, SOS Post, Bengaluru - 560 070, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/lungindia.lungindia_326_18

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Introduction: Vocal cord (VC) biopsies are usually performed with rigid laryngoscopy under general anesthesia (GA). In patients with comorbidities such as cardiovascular or pulmonary disease, the risk of GA is high, with morbidity and potential mortality. We describe VC biopsy (VCB) in such a high-risk cohort, done safely and successfully with flexible bronchoscopy-VCB (FB-VCB) and conscious sedation. Methods: FB-VCB was done in two groups of patients – the first at high risk for GA due to comorbidities and the second group where VC lesions were found incidentally in the course of FB done for other reasons. FB was done with local anesthesia and conscious sedation, and the VC lesion was identified. Flexible forceps were introduced through the working channel of the bronchoscope, and the lesions were carefully sampled. Results: FB-VCB was performed in 15 patients (14 males and 1 female) with a mean age of 60.7 ± 12.1 years. Of these 15 patients, 6 patients were poor candidates for GA due to comorbidities and 9 patients had incidental VC lesions found during bronchoscopy. A diagnosis was made in 14/15 (93.3%) patients. Complications included a mild ooze and hoarseness of voice for a few days, which did not require any intervention. Conclusion: We report one of the few series of patients with VC biopsies done with FB (FB-VCB) under conscious sedation, without significant complications. It is safe and useful in high-risk patients who are poor candidates for GA, with a good diagnostic yield.

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