Excision or destruction of lesion of pharynx, any method
CPT4 code
Name of the Procedure:
Excision or Destruction of Lesion of Pharynx, Any Method
Common names: Pharyngeal lesion removal, Throat lesion excision
Summary
This procedure involves the removal or destruction of abnormal tissue (lesion) in the pharynx (part of the throat). It can be performed using various methods such as surgical excision, laser therapy, or cauterization.
Purpose
This procedure is performed to treat abnormalities in the pharynx that might include benign growths, malignant tumors, or other lesions. The goals are to alleviate symptoms, prevent the spread of disease, and improve the patient’s quality of life.
Indications
- Persistent sore throat or pain
- Difficulty swallowing
- Unexplained bleeding from the throat
- Identified pharyngeal masses or lesions on imaging studies or physical examination
- Biopsy-confirmed malignancy or pre-malignant conditions
Preparation
- Patients may need to fast for 6-12 hours before the procedure.
- Pre-procedure assessments usually include a detailed medical history, physical examination, and imaging studies.
- Any blood-thinning medications may need to be adjusted.
- A consultation with an anesthesiologist may be necessary.
Procedure Description
- Anesthesia Administration: Local anesthesia (numbing the area) or general anesthesia (patient is asleep) is administered based on the method and patient's condition.
- Visualization: Using specialized instruments, the healthcare professional visualizes the lesion.
- Lesion Removal/Destruction: Depending on the method, the lesion is either surgically excised, vaporized with a laser, or cauterized using heat or chemicals.
- Hemostasis: Any bleeding is controlled with cauterization or sutures.
- Post-Procedure Assessment: The patient is monitored until they recover from anesthesia.
Tools used may include scalpels, lasers, electrocautery devices, or endoscopic instruments.
Duration
The procedure typically takes between 30 minutes to 2 hours, depending on the complexity and method used.
Setting
This procedure is usually performed in a hospital, outpatient clinic, or surgical center.
Personnel
- ENT Surgeon (Otolaryngologist)
- Anesthesiologist (if under general anesthesia)
- Surgical Nurses
- Surgical Technicians
Risks and Complications
- Common risks: Bleeding, infection, pain
- Rare risks: Damage to surrounding tissues, scarring, difficulty swallowing, changes in voice
- Complications are managed with medications, additional procedures, or supportive care.
Benefits
- Removal of potentially harmful or symptomatic lesions
- Relief from symptoms such as pain and difficulty swallowing
- Prevention of the progression of malignant conditions
- Improved quality of life
Benefits are generally realized soon after recovery from the procedure.
Recovery
- Post-procedure observation until anesthesia effects wear off
- Instructions may include pain management, eating soft foods, and avoiding strenuous activities
- Recovery time varies from a few days to a couple of weeks.
- Follow-up appointments for monitoring healing and addressing any concerns.
Alternatives
- Watchful waiting with regular monitoring
- Radiation therapy for malignant lesions
- Chemotherapy for advanced cancers
- Less invasive endoscopic procedures
Each alternative has its own risks and benefits, which should be discussed with a healthcare provider.
Patient Experience
During the procedure, patients under local anesthesia might feel pressure but minimal pain, while those under general anesthesia will be unconscious. Post-procedure, patients may experience sore throat, mild pain, and discomfort controlled with medications. With proper care, most patients recover smoothly with minimal complications.