Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-27T06:07:06.405Z Has data issue: false hasContentIssue false
  • English
  • Français

Intra-operative application of confocal endomicroscopy using a rigid endoscope

Published online by Cambridge University Press:  23 April 2013

T Just  and
H W Pau
T Just*
Affiliation:
Department of Otorhinolaryngology, University of Rostock, Germany
H W Pau
Affiliation:
Department of Otorhinolaryngology, University of Rostock, Germany
*
Address for correspondence: Dr Tino Just, Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Doberaner Str 137–139, D-18057 Rostock, Germany Fax: +49 381 494 8302 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To introduce the application of confocal endomicroscopy during microlaryngoscopy, to enable intra-operative evaluation of human laryngeal epithelium.

Methods:

A rigid endoscope was connected to the scanner head of a Heidelberg Retina Tomograph II confocal laser scanning system via an adapter. The endoscope was gently placed on the surface of a vocal fold through a laryngoscope during microlaryngoscopy.

Results:

The application of confocal endomicroscopy using a rigid endoscope enabled technical improvements (i.e. improved image quality, automatic volume scan, and reduced tissue pressure due to the presence of a perforation plate with central hole at the end of the endoscope) which permitted greater sensitivity and improved handling. Confocal endomicroscopy provided good quality, in vivo, en-face images and enabled an assessment of laryngeal epithelium volume.

Conclusion:

This method enables the surgeon to monitor epithelial changes in pre-malignant lesions. The combination of confocal endomicroscopy together with optical coherence tomography (as a complementary technique that provides optical cross-sections) should be further explored in a formal clinicopathological study.

Keywords

Confocal EndomicroscopyConfocal MicroscopyRigid EndoscopeLarynxVocal Cord
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 6 , June 2013 , pp. 599 - 604
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Robert Koch-Institut and Gesellschaft der epidemiologischen Krebsregister in Deutschland, eds. Krebs in Deutschland 2005/2006. Berlin: Robert Koch-Institut and Gesellschaft der epidemiologischen Krebsregister in Deutschland, 2010Google Scholar
2Robin, PE, Reid, A, Powell, DJ, McConkey, CC. The incidence of cancer of the larynx. Clin Otolaryngol Allied Sci 1991;16:198–201CrossRefGoogle ScholarPubMed
3Pantel, M, Guntinas-Lichius, O. Laryngeal carcinoma: epidemiology, risk factors and survival [in German]. HNO 2012;60:32–40CrossRefGoogle ScholarPubMed
4Smith, JC, Johnson, JT, Cognetti, DM, Landsittel, DP, Gooding, WE, Cano, ER et al. Quality of life, functional outcome, and costs of early glottic cancer. Laryngoscope 2003;113:68–76CrossRefGoogle ScholarPubMed
5Arens, C, Vorwerk, U, Just, T, Betz, CS, Kraft, M. Advances in endoscopic diagnosis of dysplasia and carcinoma of the larynx [in German]. HNO 2012;60:44–52CrossRefGoogle ScholarPubMed
6Andrea, M, Dias, O, Santos, A. Contact endoscopy during microlaryngeal surgery: a new technique for endoscopic examination of the larynx. Ann Otol Rhinol Laryngol 1995;104:333–9CrossRefGoogle ScholarPubMed
7Just, T, Stave, J, Boltze, C, Wree, A, Kramp, B, Guthoff, RF et al. Laser scanning microscopy of the human larynx mucosa: a preliminary, ex vivo study. Laryngoscope 2006;116:1136–41CrossRefGoogle ScholarPubMed
8Just, T, Stave, J, Kreutzer, HJ, Guthoff, R, Pau, HW. Confocal microscopic evaluation of epithelia of the larynx [in German]. Laryngorhinootologie 2007;86:644–8CrossRefGoogle ScholarPubMed
9Kraft, M, Lüerssen, K, Lubatschowski, H, Woenckhaus, J, Schoberlein, S, Glanz, H et al. Mucosal lesions in the larynx: predictive value of new imaging modalities for a histological diagnosis [in German]. HNO 2008;56:609–13CrossRefGoogle ScholarPubMed
10SPIE Digital Library: OCT in the field of laryngology: further perspectives. In: http://dx.doi.org/10.1117/12.886959 [17 February 2011]CrossRefGoogle Scholar
11Farahati, B, Stachs, O, Prall, F, Stave, J, Guthoff, R, Pau, HW et al. Rigid confocal endoscopy for in vivo imaging of experimental oral squamous intra-epithelial lesions. J Oral Pathol Med 2010;39:318–27CrossRefGoogle ScholarPubMed
12SPIE Digital Library: Confocal endomicroscopy of the larynx. In: http://dx.doi.org/10.1117/12.921265 [9 February 2012]CrossRefGoogle Scholar
13World Health Organization. Classification of tumors. Pathology & genetics. Head and neck tumours. International Agency for Research on Cancer (IARC). In: Barnes, L, Everson, JW, Reichart, P, Sidransky, D, eds. Head and Neck Tumors. Lyon: IARC Press, 2005;177–80Google Scholar
14Just, T, Lankenau, E, Prall, F, Hüttmann, G, Pau, HW, Sommer, K. Optical coherence tomography allows for the reliable identification of laryngeal epithelial dysplasia and for precise biopsy: a clinicopathological study of 61 patients undergoing microlaryngoscopy. Laryngoscope 2010;120:1964–70CrossRefGoogle ScholarPubMed
15Sigston, E, De Mones, E, Babin, E, Hans, S, Hartl, DM, Clement, P et al. Early-stage glottic cancer. Arch Otolaryngol Head Neck Surg 2006;132:147–52CrossRefGoogle ScholarPubMed
16Hsiung, PL, Hardy, J, Friedland, S. Detection of colonic dysplasia in vivo using targeted heptapeptide and confocal microendoscopy. Nat Med 2008;14:454–8CrossRefGoogle ScholarPubMed