Contact endoscopy for the evaluation of the pharyngeal and laryngeal mucosa.
OBJECTIVE
Contact endoscopy is a noninvasive tool that allows in vivo and in situ examination of superficial mucosa. Its use for early diagnosis of cancerous lesions of the oropharynx and larynx has not been evaluated. The aim of the study was to validate contact endoscopy for the examination of pharyngeal and laryngeal mucosa.


METHODS
Prospective clinical study.


METHODS
Superficial cells of the mucosa were stained with methylene blue and examined with contact endoscopes. The documented images were assessed by a cytopathologist and by an otolaryngologist independently for each patient. Biopsies for histopathological examination of the area were performed and correlated with contact endoscopic findings of both examiners.


RESULTS
Of the 42 examined specimen, 32 (76.2%) showed benign changes in the histological analysis. Squamous cell carcinoma was revealed in 10 specimen (23.8%). Using contact endoscopy, the cytopathologist accurately identified 90.6% of the benign findings (29 of 32); however, only seven of 10 (70%) carcinomas were correctly categorized. In comparison, the otolaryngologist made a correct diagnosis in 93.75% (30 of 32) of the benign and in 90% (nine of 10) of the malignant cases. Thus, a sensitivity of 90% and a specificity of 93.75% can be achieved by contact endoscopy.


CONCLUSIONS
Contact endoscopy offers valuable support for the evaluation of oropharyngeal, hypopharyngeal, and laryngeal mucosa. Contact endoscopy can be a useful contribution to rapid intraoperative evaluation of mucosal alterations for early diagnosis of tumors and might reduce diagnostic biopsy sampling. Even so, it does not replace biopsy sampling.
Warnecke
Athanasia
A
Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Hannover, Hannover, Germany.
Averbeck
Thomas
T
Leinung
Martin
M
Soudah
Bisharah
B
Wenzel
Gentiana I
GI
Kreipe
Hans-Heinrich
HH
Lenarz
Thomas
T
Stöver
Timo
T
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology*; D004396:Coloring Agents; D055088:Early Detection of Cancer; D019723:Endoscopes; D004724:Endoscopy; D005260:Female; D006801:Humans; D007820:Laryngeal Mucosa / Q000473:pathology*; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010610:Pharyngeal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D010614:Pharynx / Q000473:pathology*; D012680:Sensitivity and Specificity; D055815:Young Adult
D004396:Coloring Agents; D008751:Methylene Blue