Use of a transnasal flexible laryngoscope tip for laryngeal culturing: A novel in-office technique

Background In-office culture of the larynx using a flexible laryngoscope tip can help identify laryngeal pathogens in cases of laryngitis. Objective This retrospective case series aimed to investigate the feasibility of in-office laryngoscope tip culture to identify laryngeal pathogens and help guide medical treatment. Methods This case series consists of 8 patients who underwent 11 in-office laryngeal cultures using the tip of the flexible laryngoscope. Concurrent nasal cultures were performed on two patients to assess for possible nasal contamination of these laryngoscope tip cultures. Results Nine patients underwent laryngeal culture with laryngoscope tip in-office, with two patients undergoing repeat swabs for a total of eleven swabs. Then, 8 of 11 swabs (73%) grew methicillin-sensitive Staphylococcus aureus, while 1 of 11 (9.1%) swabs grew methicillin-resistant S. aureus. Three of eleven swabs (27%) grew Candida species. Concurrent culture was performed of the contralateral nasal cavity in two patients to assess for the possibility of nasal contamination of laryngoscope tip cultures. Concurrent contralateral nasal cultures grew distinct pathogens compared to the laryngeal cultures, suggesting that nasal contamination did not occur. Conclusion In-office laryngoscope tip culture allows safe identification of laryngeal pathogens in an ambulatory setting. In-office laryngoscope tip culture can help guide medical treatment of laryngeal infections. Level of Evidence 4