Journal
JOURNAL OF LARYNGOLOGY AND OTOLOGY
Volume 127, Issue 6, Pages 599-604Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0022215113000765
Keywords
Confocal Endomicroscopy; Confocal Microscopy; Rigid Endoscope; Larynx; Vocal Cord
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Objective: To introduce the application of confocal endomicroscopy during microlaryngoscopy, to enable intraoperative 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.
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