Optical coherence tomography-enhanced microlaryngoscopy: preliminary report of a noncontact optical coherence tomography system integrated with a surgical microscope.
OBJECTIVE
Optical coherence tomography (OCT) is a new imaging modality that uses near-infrared light to produce cross-sectional images of tissue with a resolution approaching that of light microscopy. We have previously reported use of OCT imaging of the vocal folds (VFs) during direct laryngoscopy with a probe held in contact or near-contact with the VFs. This aim of this study was to develop and evaluate a novel OCT system integrated with a surgical microscope to allow hands-free OCT imaging of the VFs, which could be performed simultaneously with microscopic visualization.


METHODS
We performed a prospective evaluation of a new method of acquiring OCT images of the VFs.


RESULTS
An OCT system was successfully integrated with a surgical microscope to permit noncontact OCT imaging of the VFs of 10 patients. With this novel device we were able to identify VF epithelium and lamina propria; however, the resolution was reduced compared to that achieved with the standard contact or near-contact OCT.


CONCLUSIONS
Optical coherence tomography is able to produce high-resolution images of vocal fold mucosa to a maximum depth of 1.6 mm. It may be used in the diagnosis of VF lesions, particularly early squamous cell carcinoma, in which OCT can show disruption of the basement membrane. Mounting the OCT device directly onto the operating microscope allows hands-free noncontact OCT imaging and simultaneous conventional microscopic visualization of the VFs. However, the lateral resolution of the OCT microscope system is 50 microm, in contrast to the conventional handheld probe system (10 microm). Although such images at this resolution are still useful clinically, improved resolution would enhance the system's performance, potentially enabling real-time OCT-guided microsurgery of the larynx.
Vokes
David E
DE
Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine Medical Center, Orange, California, USA.
Jackson
Ryan
R
Guo
Shuguang
S
Perez
Jorge A
JA
Su
Jianping
J
Ridgway
James M
JM
Armstrong
William B
WB
Chen
Zhongping
Z
Wong
Brian J F
BJ
D006801:Humans; D007820:Laryngeal Mucosa / Q000166:cytology; D007828:Laryngoscopy; D008853:Microscopy; D009092:Mucous Membrane / Q000166:cytology; D041623:Tomography, Optical Coherence / Q000295:instrumentation* / Q000379:methods; D014827:Vocal Cords / Q000166:cytology*