As otolaryngology has moved toward minimally invasive procedures in every subspecialty, there has been a parallel trend to perform these procedures in the office setting, when possible. Physicians and patients alike can derive benefits from moving procedures from the hospital operating room to the office exam room. Physicians have more flexibility in scheduling, delays associated with staff shift changes and equipment turnover are eliminated, time can be used more efficiently, and more patients can be seen. Patients are more comfortable in a familiar environment, require less time away from their regular schedules, have decreased anesthesia requirements, are not exposed to hospital acquired infectious organisms, and often have a lower insurance copay for officebased procedures.
In this text, we cover the foundation of knowledge a surgeon must have to prepare for office-based procedures, including anatomy, radiology, and basic endoscopic skills. We review the basic preparatory steps involved such as proper patient selection, room setup, and local anesthetic techniques, and then present multiple rhinologic procedures that can be performed in the office setting. We have asked expert rhinologists across the subspecialty to share their techniques in this text, and we thank them for their excellent contributions. We have also compiled a DVD of selected surgical procedures to help the reader obtain a more complete and thorough understanding of these procedures. We hope this book will educate surgeons at all stages of their career, whether otolaryngology residents or those who have been practicing for many years, and allow them to develop a new and fulfilling aspect of their practice as otolaryngologists.