A Prospective, Double-Blind, Randomized Study on the Use of a Topical Anesthetic, Vasoconstrictor, and Placebo During Transnasal Flexible Fiberoptic Endoscopy The purpose of the present study was to compare patient comfort levels following administration of a topical anesthetic, vasoconstrictor, placebo, or nothing to the nasal mucosa prior to flexible fiberoptic transnasal endoscopy. Using a prospective, double-blind, randomized design, 152 consecutive patients were randomly assigned to receive a topical anesthetic (N ... Research Article
Research Article  |   December 01, 1997
A Prospective, Double-Blind, Randomized Study on the Use of a Topical Anesthetic, Vasoconstrictor, and Placebo During Transnasal Flexible Fiberoptic Endoscopy
 
Author Affiliations & Notes
  • Steven B. Leder, PhD
    Department of Surgery, Section of Otolaryngology Yale University School of Medicine New Haven, CT
    Yale University School of Medicine, Department of Surgery, Section of Otolaryngology, Communication Disorders Center, 20 York Street, YPB-468, New Haven, CT 06504
  • Douglas A. Ross
    Department of Surgery, Section of Otolaryngology Yale University School of Medicine New Haven, CT
  • Kenneth B. Briskin
    Department of Surgery, Section of Otolaryngology Yale University School of Medicine New Haven, CT
  • Clarence T. Sasaki
    Department of Surgery, Section of Otolaryngology Yale University School of Medicine New Haven, CT
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Swallowing, Dysphagia & Feeding Disorders / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   December 01, 1997
A Prospective, Double-Blind, Randomized Study on the Use of a Topical Anesthetic, Vasoconstrictor, and Placebo During Transnasal Flexible Fiberoptic Endoscopy
Journal of Speech, Language, and Hearing Research, December 1997, Vol. 40, 1352-1357. doi:10.1044/jslhr.4006.1352
History: Received January 9, 1997 , Accepted June 10, 1997
 
Journal of Speech, Language, and Hearing Research, December 1997, Vol. 40, 1352-1357. doi:10.1044/jslhr.4006.1352
History: Received January 9, 1997; Accepted June 10, 1997

The purpose of the present study was to compare patient comfort levels following administration of a topical anesthetic, vasoconstrictor, placebo, or nothing to the nasal mucosa prior to flexible fiberoptic transnasal endoscopy. Using a prospective, double-blind, randomized design, 152 consecutive patients were randomly assigned to receive a topical anesthetic (N = 54), vasoconstrictor (N=50), or placebo (N=48). No significant differences were found among the three variables. An additional 50 consecutive patients had endoscopy performed without administration of any substance to the nares, and no significant differences were found among the four variables (N=202). It was concluded that speech-language pathologists can perform independent and comfortable transnasal endoscopy without administration of any substance to the nasal mucosa. Flexible fiberoptic endoscopy, however, should be performed by experienced clinicians with care taken to examine visually the patency of both nares for ease and comfort of scope insertion.

Acknowledgments
We gratefully acknowledge the help of D. Conte, V. S. Cox, J. Joe, and T. Taylor during the data collection phase of this study, and L. M. Bartoshuk for the placebo recipe. This research was supported, in part, by the McFadden, Harmon, and Mirikitani Endowments.
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