Systematic intraoperative application of confocal endomicroscopy for early detection and resection of squamous cell carcinoma of the head and neck: a preliminary report.

Publisher: American Medical Association Country of Publication: United States NLM ID: 8603209 Publication Model: Print Cited Medium: Internet ISSN: 1538-361X (Electronic) Linking ISSN: 08864470 NLM ISO Abbreviation: Arch Otolaryngol Head Neck Surg Subsets: MEDLINE

Original Publication: [Chicago, IL] : American Medical Association, [c1986-

Endoscopes*; Carcinoma, Squamous Cell/*diagnosis ; Carcinoma, Squamous Cell/*surgery ; Endoscopy/*methods ; Head and Neck Neoplasms/*diagnosis ; Head and Neck Neoplasms/*surgery ; Laryngeal Neoplasms/*diagnosis ; Laryngeal Neoplasms/*surgery ; Microscopy, Confocal/*methods ; Pharyngeal Neoplasms/*diagnosis ; Pharyngeal Neoplasms/*surgery; Carcinoma, Squamous Cell/pathology ; Contrast Media ; Early Diagnosis ; Equipment Design ; Fluorescein ; Germany ; Head and Neck Neoplasms/pathology ; Humans ; Intraoperative Care ; Laryngeal Neoplasms/pathology ; Pharyngeal Neoplasms/pathology ; Prospective Studies ; Reproducibility of Results

Objective: To use intraoperative confocal endomicroscopy for early detection and resection of squamous cell carcinoma (SCC) of the head and neck. A preliminary report.
Design: Prospective case series.
Setting: Tertiary referral hospital.
Patients: Fifteen consecutive patients with SCC of the oral cavity, hypopharynx, and larynx were included from the Department of Otolaryngology-Head and Neck Surgery, HSK Dr Horst Schmidt Kliniken GmbH, Wiesbaden, Germany
Interventions: Confocal endomicroscopy was performed during diagnostic and therapeutic procedures with a prototype of a rigid laser endoscope in combination with the already available technology of autofluorescence.
Main Outcome Measures: Real-time visualization of cellular and subcellular details during endoscopy. Diagnostic scores were applied to differentiate dysplastic and malignant mucosal changes of SCC of the head and neck from normal squamous cell mucosa using this method. Results were correlated with the well-established gold standard, histologic analysis.
Results: Dysplastic and malignant changes of head and neck squamous cell mucosa were endoscopically determined by this unique in vivo application of confocal laser endomicroscopy using a rigid probe.
Conclusions: We present preliminary and descriptive data using this novel technology in vivo. Considering the impact of a virtual real-time histologic analysis, this technology points to a very promising development. It may carry potential for quicker intraoperative diagnosis, less need for multiple frozen sections, and more precise resection margins.

0 (Contrast Media)
TPY09G7XIR (Fluorescein)

Date Created: 20120418 Date Completed: 20120604 Latest Revision: 20151119

20231215

10.1001/archoto.2012.213

22508625