title: Optical and molecular techniques to identify tumor margins within the larynx.
abstract: Failure to remove tumor cells from the larynx significantly increases the risk of local recurrence following surgical excision. Healthy tissue must be preserved to optimize long-term vocal and swallowing function. It is essential to accurately distinguish between healthy mucosa, dysplasia, and invasive carcinoma. Optical and molecular examining technologies have been developed to improve tumor margin identification in vivo. We aimed to review the efficacy of these technologies. Published articles were identified using MEDLINE, EMBASE, and Cochrane central register of controlled trials (CENTRAL). Randomized clinical trials are required to establish the benefit to patients and cost to the health service of using 5-aminolevulinic acid (ALA)-induced fluorescent imaging, contact endoscopy, and optical coherence tomography (OCT). Furthermore, primary research is required to validate other techniques, such as confocal endomicroscopy and Raman spectroscopy, and to develop their clinical applications in the larynx.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Royal National Throat, Nose, and Ear Hospital, London, United Kingdom. mail@owainhughes.com
authors.forename: Owain R
authors.initials: OR
authors.lastname: Hughes
authors.forename: Nicholas
authors.initials: N
authors.lastname: Stone
authors.forename: Marcel
authors.initials: M
authors.lastname: Kraft
authors.forename: Christoph
authors.initials: C
authors.lastname: Arens
authors.forename: Martin A
authors.initials: MA
authors.lastname: Birchall
mesh_terms: D000622:Aminolevulinic Acid; D005453:Fluorescence; D006801:Humans; D007820:Laryngeal Mucosa / Q000473:pathology*; D007822:Laryngeal Neoplasms / Q000473:pathology*; D007828:Laryngoscopy / Q000379:methods; D007830:Larynx / Q000473:pathology*; D018613:Microscopy, Confocal; D017319:Photosensitizing Agents; D013059:Spectrum Analysis, Raman; D041623:Tomography, Optical Coherence
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid