Topical Anesthesia to the Larynx

The application of topical anesthesia to the larynx is safe and effective in office-based laryngeal surgery. It can be performed using various techniques, the choice being based on the physician’s preference and on patient-related factors. Obscure anatomic cervical landmarks should direct the surgeon toward the transnasal or transoral approach, whereas a strong gag reflex and narrow oropharynx might direct the surgeon toward a transcervical approach. Advanced age, poor medical condition, and high level of patient anxiety could be deterring factors that prohibit office-based laryngeal surgery.