Method of Laryngeal Biopsy

Laryngeal biopsies were done either in the office or in the operating room as previously described. Briefly, in the office setting, atomized 4% lidocaine and oxymetazoline were used for local anesthetization. Biopsies were done with endoscopic biopsy forceps under the guidance of both white-light laryngoscopy and VC using i-scan (Pentax). For operative biopsies, briefly the laryngeal lesion was scrutinized under high magnification of the operating microscope, especially the suspicious areas seen on preoperative laryngoscopy. Biopsies sampled the most irregular, abnormal-appearing focus of a keratotic lesion as previously described.⁴ The KTP laser was then used to photoablate glottic keratosis based on intraoperative pathology, with the goal of preserving superficial lamina propria for optimal phonatory outcome.