Use of Narrow Band Imaging - enhanced Contact Endoscopy for the intraoperative detection of perpendicular vascular lesions of the vocal folds

Introduction The endoscopic detection of perpendicular vascular changes (PVC) of the vocal folds has been associated with laryngeal cancer, presursor lesions and laryngeal papillomatosis, according to a classification proposed by the European Laryngological Society (ELS). NBI-enhanced contact endoscopy (NBI-CE) enables high-contrast, real-time visualization of vascular changes during microlaryngoscopy.

Methods Between 01.01.2017 and 31.08.2018, 68 patients with a vocal cord lesion were included in the present study. Prior to the biopsy, images of different vascular patterns were taken using NBI-CE. Three ENT specialists ("experienced observers") and three ENT residents ("inexperienced observers") independently evaluated each of the 68 image series to detect PVC. The prevalence of PVC-positive lesions for the various histological diagnoses and the interobserver agreement in the detection of PVC for the different observer groups were determined.

Results The prevalence of PVC-positive lesions among the various observers ranged from 37.5 to 100% for SCC, 41.2 and 88.2% for dysplasia, 90.9 to 100% for papillomatosis, and 12.5 to 21.9% for the remaining benign lesions. The level of agreement among observers in the identification of PVC was moderate (kappa 0.510) in the inexperienced group and almost perfect (kappa 0.920) in the experienced group.

Conclusion NBI-CE is a valuable endoscopic tool for experienced as well as inexperienced observers in the intraoperative detection of PVC and the differential diagnosis of laryngeal lesions.

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Publication History

Article published online:
10 June 2020