Implementation of Office-Based Procedures: Experience and Learning Curve of a Single Center.

OBJECTIVE

To report surgical outcomes and learning curve findings of a single laryngeal surgeon throughout the implementation of an office-based laryngology setting.

METHODS

From January 2022 to January 2025, 114 consecutive patients were treated with office-based laryngological procedures in the EpiCURA hospital (Belgium). The following outcomes were prospectively collected: gender, age, indications, laser settings, setting, anesthesia and procedure duration, pain (visual analog scale), laryngeal sensory testing, exposure, immediate adverse events, patient compliance, local anesthesia efficacy, and patient satisfaction. Pitfalls were prospectively collected, and the impact of related adjustments was investigated.

RESULTS

A total of 142 office-based laryngology procedures were performed (114 patients), with a 96.5% success rate. Primary indications included vocal fold augmentation (30.3%) and laser surgery for Reinke edema (16.9%). Mean procedure duration decreased significantly from 13.8 to 8.0 minutes over time. The learning curve statistics reported an overall stability of outcomes (time of procedure) after 101 cases for all office-based procedures, with minimum case numbers of 41 for polyp/Reinke edema and 38 for vocal fold augmentation, respectively. Key improvements included changing anesthesia concentration, adding preoperative speech therapy consultation, modifying laser settings, and introducing preoperative anxiolytics. These adjustments significantly reduced procedure duration, patient anxiety, dysphagia, and dyspnea while maintaining high satisfaction rates.

CONCLUSION

Office-based laryngology shows a significant learning curve with procedure duration decreasing by 42% over three years with consistent patient satisfaction. Key adjustments may significantly reduce procedure duration, patient anxiety, dysphagia, and dyspnea while maintaining high satisfaction rates.