Key Highlights
This retrospective study provides evidence that anatomical variations in upper airway fat distribution significantly influence patient comfort during transnasal office-based laryngeal surgery (OBLS). The research demonstrates that higher parapharyngeal fat volume at the palatal level correlates with lower satisfaction scores, suggesting that preoperative assessment of vocal tract anatomy may help identify patients at risk for poor procedural tolerance. These findings have important implications for patient selection and procedural planning in the growing field of awake office-based laryngeal interventions.