Optical coherence tomography monitoring for laser surgery of laryngeal carcinoma.
OBJECTIVE
The goal of this study is to apply a new bioimaging modality, the Optical Coherence Tomography (OCT), for intraoperative control in laser surgery of laryngeal carcinoma.


METHODS
We studied 26 patients with laryngeal carcinoma in situ and in T(1), T(2) stage. We used an endoscopic OCT device for imaging at a wavelength of 0.83 microm with the acquisition rate of approximately 0.5 frames/s for a single (200 x 200 pixel) tomogram. All patients were operated with a surgical YAG:Nd laser at two switchable wavelengths of 1.44 microm and 1.32 microm by laryngofissure, direct microlaryngoscopy, and fibrolaryngoscopy.


RESULTS
Information on structural alterations in laryngeal mucosa to the depth of 2 mm, obtained by OCT, makes it possible to precisely locate tumor borders, thus giving an opportunity to control the surgical treatment of laryngeal carcinoma. The YAG:Nd laser scalpel with wavelengths of 1.32 microm and 1.44 microm is successful in surgical procedures both in open and closed larynx due to efficient coagulation and minimization of collateral tissue damage area. Combination of the two wavelengths in the single laser unit and intraoperative OCT monitoring result is a new modality for minimally invasive larynx surgery.


CONCLUSIONS
OCT is promising to become a new diagnosing method of laryngeal carcinoma and a tool for laser treatment monitoring.
Shakhov
A V
AV
Nizhny Novgorod Medical Academy, Uljanov St. 46, Nizhny Novgorod, 603600, Russia.
Terentjeva
A B
AB
Kamensky
V A
VA
Snopova
L B
LB
Gelikonov
V M
VM
Feldchtein
F I
FI
Sergeev
A M
AM
D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007820:Laryngeal Mucosa / Q000473:pathology; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D007828:Laryngoscopy; D053685:Laser Therapy; D019060:Minimally Invasive Surgical Procedures; D016343:Monitoring, Intraoperative; D014054:Tomography / Q000379:methods