European Practice Consensus on Office-Based Laryngology.

OBJECTIVE: To establish European consensus on indications, contraindications, and periprocedural management of office-based laryngology (OBL) procedures. METHODS: Twenty-five laryngologists from the British Laryngological Association, European Laryngological Society, and Union of European Phoniatricians were included in a modified Delphi process to establish statements about indications, contraindications, and periprocedural clinical considerations for OBL procedures. The Delphi was organized through a maximum of four anonymous voting rounds, each separated by revision of unaccepted statements. Consensus required ≥ 80% agreement (agree/strongly agree); statements with 60%-79.9% agreement were revised for re-voting. GRADE system was used for validated statement assessment. RESULTS: Sixty statements were approved across two voting rounds. The first round validated 49 statements, and 11 statements were approved after revision (expert intraclass correlation coefficient: 0.798 (95% CI: 0.645-0.911)). Statements covered preprocedural considerations (n = 6), indications and contraindications (n = 11), technical considerations (n = 17), vocal fold augmentation (n = 7), postprocedural care and success criteria (n = 14), and environmental, economic, and societal outcomes (n = 5). Primary indications included polyps, Reinke's edema, varices, leukoplakia, biopsies, granulomas, recurrent respiratory papillomatosis, and selected indications for vocal fold augmentation. CONCLUSION: This European consensus provides a unified consensus on indications, contraindications, and perioperative management of OBL procedures. LEVEL OF EVIDENCE: NA.