title: Intraoperative narrow band imaging better delineates superficial resection margins during transoral laser microsurgery for early glottic cancer.
abstract: OBJECTIVE
  The high rate of positive margins after transoral laser microsurgery (TLM) remains a matter of debate. This study investigates the effect of intraoperative narrow band imaging (NBI) examination on the incidence of positive superficial surgical margins in early glottic cancer treated by TLM.
  
  
  METHODS
  Between January 2012 and October 2013, 82 patients affected by Tis-T1a glottic cancer were treated with TLM by type I or II cordectomies. Intraoperative NBI evaluation was performed using 0-degree and 70-degree rigid telescopes. Surgical specimens were oriented by marking the superior edge with black ink and sent to a dedicated pathologist. Comparison between the rate of positive superficial margins in the present cohort and in a matched historical control group treated in the same way without intraoperative NBI was calculated by chi-square test.
  
  
  RESULTS
  At histopathological examination, all surgical margins were negative in 70 patients, whereas 7 had positive deep margins, 2 close, and 3 positive superficial margins. The rate of positive superficial margins was thus 3.6% in the present group and 23.7% in the control cohort (P<.001).
  
  
  CONCLUSIONS
  Routine use of intraoperative NBI increases the accuracy of neoplastic superficial spreading evaluation during TLM for early glottic cancer.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Garofolo
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Italy ceceplaza@libero.it.
authors.forename: Cesare
authors.initials: C
authors.lastname: Piazza
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Del Bon
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Mangili
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Guastini
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mora
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Peretti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D009055:Mouth; D062048:Narrow Band Imaging / Q000379:methods*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009367:Neoplasm Staging; D012189:Retrospective Studies
keywords: early glottic cancer; narrow band imaging; resection margins; transoral laser microsurgery