Differences in the diagnostic value between fiberoptic and high definition laryngoscopy for the characterisation of pharyngeal and laryngeal lesions: A multi-observer paired analysis of videos.

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Abstract

High definition laryngoscopy (HDL) could lead to better interpretation of the pharyngeal and laryngeal mucosa than regularly used fiberoptic laryngoscopy (FOL). The primary aim of this study is to quantify the diagnostic advantage of HDL over FOL in detecting mucosal anomalies in general, in differentiating malignant from benign lesions and in predicting specific histological entities. The secondary aim is to analyse image quality of both laryngoscopes.

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Laryngeal cancer: diagnosis and preoperative work-up.

Eugene A Chu, Young Kim (2008)

Laryngeal carcinoma is the eleventh-most common form of cancer among men worldwide and is the second-most common malignancy of the head and neck. The primary functions of the larynx involve phonation, respiration, and deglutition but it also contributes to taste and smell by allowing the movement of air over the special sense organs. Thus, loss of laryngeal function affects speech and swallowing and some of the senses that allow us to enjoy the world. Moreover, total laryngectomy bypasses the critical humidification function of the upper aerodigestive tract that renders pulmonary toiletry problematic for these patients. With relatively little change in mortality since the 1970s, recent research has focused not only on improving survival but on laryngeal preservation modalities.

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Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites.

Chikatoshi Katada, Manabu Muto, Shigeaki Yoshida … (2004)

Head and neck squamous cell carcinoma typically is diagnosed at an advanced stage, and the prognosis for patients with this type of malignancy is poor. Detection of these lesions at an earlier stage (e.g., as carcinoma in situ) would be of clear benefit to patients. However, it has been extremely difficult to detect carcinoma in situ at head and neck mucosal sites during routine endoscopy, even after numerous passes of the endoscope through the oral cavity and the pharynx. The current clinical investigation was performed during routine endoscopic screening or surveillance procedures. The authors used a novel optical technique, known as narrowband imaging (NBI) that allows noninvasive visualization of the microvascular structure of an organ's surface using reflected light. Between April 2002 and August 2003, 34 consecutive superficial lesions were found in 18 patients. Multifocal carcinoma was found in 5 patients (28%). The median age of the patients examined was 59.5 years (range, 43-71 years), and 83% of all patients were male. All lesions exhibited a microvascular proliferation pattern on magnified NBI. Thirteen patients with a combined total of 29 lesions underwent endoscopic resection under general anesthesia. The pyriform sinus was the most frequent primary site (66%; 19 of 29 lesions). The median tumor diameter was 20 mm (range, 1.3-40 mm). Twenty-one lesions (72%) were histologically confirmed to be carcinoma in situ, and the remaining lesions showed evidence of microinvasion (0.05-1 mm) beneath the epithelium. Vascular invasion was observed in only one lesion. The median hospital stay was 10 days (range, 4-18 days). All patients were discharged without severe complications. After a median follow-up period of 8 months (range, 1-16 months), there were no cases of local disease recurrence. The authors stress the importance of endoscopic detection of superficial carcinoma at oropharyngeal and hypopharyngeal mucosal sites. NBI is a promising and potentially powerful tool for identifying carcinomas at an earlier stage during routine endoscopic examination. Copyright 2004 American Cancer Society.

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High-Definition Medicine

Ali Torkamani, Kristian Andersen, Steven Steinhubl … (2017)

The foundation for a new era of data-driven medicine has been set by recent technological advances that enable the assessment and management of human health at an unprecedented level of resolution – what we refer to as high definition medicine. Our ability to assess human health in high definition is enabled, in part, by advances in DNA sequencing, physiological and environmental monitoring, advanced imaging and behavioral tracking. Our ability to understand and act upon these observations at equally high precision is driven by advances in genome editing, cellular reprogramming, tissue engineering, and information technologies, especially artificial intelligence. In this review, we will examine the core disciplines that enable high definition medicine, and project how these technologies will alter the future of medicine.

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Author and article information

Journal

Journal ID (iso-abbrev): Clin Otolaryngol

Title: Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

Publisher: Wiley

ISSN (Electronic): 1749-4486

ISSN (Print): 1749-4478

Publication date (Electronic): January 2020

Volume: 45

Issue: 1

Affiliations

[1 ] Department of Otorhinolaryngology - Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

[2 ] Department of Otorhinolaryngology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Article

DOI: 10.1111/coa.13476

PMC ID: 6972529

PubMed ID: 31747481

SO-VID: 6861fed6-2cc7-47f2-9b13-215b386e741f

History

Keywords: laryngeal mucosa,laryngoscopy,larynx,mucous membrane,neoplasms,pharynx,sensitivity and specificity

Data availability:

Keywords: laryngeal mucosa, laryngoscopy, larynx, mucous membrane, neoplasms, pharynx, sensitivity and specificity

Differences in the diagnostic value between fiberoptic and high definition laryngoscopy for the characterisation of pharyngeal and laryngeal lesions: A multi-observer paired analysis of videos.

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Most cited references 25

Laryngeal cancer: diagnosis and preoperative work-up.

Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites.

High-Definition Medicine

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