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Objectives/Hypothesis Definitive tissue diagnosis for lesions warranting biopsy is shifting from the operating room to the office. Safety, tolerance, factors related to successful biopsy, and time to treatment are not well-defined. Methods Retrospective review of 116 patients undergoing in-office biopsy of oropharynx, larynx, or hypopharynx were included. Logistic regression determined if demographics, site, T-stage, or approach (transoral/transnasal) were related to success. Time to definitive treatment was also analyzed. Results Ninety-two transnasal and 24 transoral biopsies were performed on 73 laryngeal, 35 oropharyngeal, and 8 hypopharyngeal lesions. Of those, 97 of 116 diagnoses were made in-office. There were no complications; two patients did not tolerate the procedure. Success was not related to age ( P = 0.374), site ( P = 0.527), T-stage ( P = 0.587), or approach ( P = 0.566). Time to treatment was 24.2 ± 13.9 days with successful office biopsy and 48.8 ± 49.4 days without. Conclusions High procedural completion rate was observed across patients, sites, and approaches. All patients should be considered for in-office biopsy, a more time- and cost-effective option leading to earlier treatment. Level of Evidence 4. Laryngoscope, 125:919-923, 2015 [ABSTRACT FROM AUTHOR]

Objective: Prophylactic ligation of the external carotid artery (ECA) during oropharyngeal squamous cell carcinoma (OPSCC) resection is known to reduce severe postoperative oropharyngeal bleeding events, however, there is limited research on whether bleed rates vary between selective ligation of individual vessels or total ligation of the ECA. This study assesses outcomes related to total versus selective ligation of the ECA in patients who underwent transoral resection for OPSCC of the base of tongue or palatine tonsils., Study Design: Retrospective review., Setting: Patients who underwent OPSCC resection of the base of tongue or palatine tonsils at a single institution between October 2019 and September 2023., Methods: Bleeding events within 30 days of surgery from the oropharyngeal surgical site were analyzed as well as other potential complications including stroke. Descriptive statistics and Fisher's exact test or χ 2 testing were used to analyze the data., Results: Of 140 patients, 51 underwent base of tongue resection, and 89 had tonsillar resection. Total ECA ligation was performed in 56 patients, while 80 had selective ligation. There was no significant difference in oropharyngeal bleeding between the 2 groups (total 3.8% vs selective 3.7% P > .05). One patient in the total ECA ligation group had a stroke after resection (1.9%). On multivariate analysis, age (P = .024) and radiation exposure (P = .011) were found to be significant risk factors for hemorrhage., Conclusion: Selective ligation of external carotid vessels versus total ligation of the ECA shows similar rates of oropharyngeal bleeding without any significant risk of stroke., (© 2024 The Author(s). Otolaryngology‐Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology‐Head and Neck Surgery Foundation.)