Reliability of office-based narrow-band imaging-guided flexible laryngoscopic tissue samplings.
Direct suspension laryngoscopic biopsy performed under general anesthesia is the conventional management for obtaining pathological diagnosis for neoplasms of the larynx, oropharynx, and hypopharynx. Since the development of distal chip laryngoscopy and digital imaging systems, transnasal flexible laryngoscopy tissue sampling has gained popularity as an office-based procedure. Additional assessment with narrow-band imaging (NBI) can help to increase the diagnostic yield. The aim of the study was to evaluate the accuracy, sensitivity, and specificity of a novel diagnostic tool: office-based NBI (OB-NBI) flexible laryngoscopic tissue sampling.



Retrospective chart review performed in a tertiary referral medical center in Taiwan.



From January 2010 to February 2013, 90 consecutive patients received OB-NBI biopsies. The accuracies of the OB-NBI biopsies were compared among locations, tumor sizes, head and neck cancer histories, and other factors.



All patients had completed the procedure without life-threatening complications. The overall sensitivity and specificity were 97.2% and 100%, respectively, with a diagnostic accuracy of 98.9%. Accuracy was not affected by tumor size, location, learning curves, or previous head and neck cancer history.



We present an integrated technique that merges the safety and versatility of flexible laryngoscopy with the diagnostic power of NBI to produce a promising method of high accuracy and minimal morbidity.



4 Laryngoscope, 126:2764-2769, 2016.
Department of Otolaryngology-Hand and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Catherine
C
Chang
Department of Otolaryngology-Hand and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.|School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Wan-Ni
WN
Lin
Department of Otolaryngology-Hand and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.|School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Li-Jen
LJ
Hsin
Department of Otolaryngology-Hand and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.|School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Li-Ang
LA
Lee
Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan.
Chien-Yu
CY
Lin
Department of Otolaryngology-Hand and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.|School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Hsueh-Yu
HY
Li
Department of Otolaryngology-Hand and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.|School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chun-Ta
CT
Liao
Department of Otolaryngology-Hand and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.|School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Tuan-Jen
TJ
Fang
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D010039:Otorhinolaryngologic Neoplasms / Q000473:pathology*; D010614:Pharynx / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
Office biopsy; flexible laryngoscopy; narrow-band imaging