First validation of morphologic criteria of malignancy in endonasal confocal laserendomicroscopic imaging

Introduction Probe-based confocal laser endomicroscopy (p-CLE) is a method for intravital visualization of mucosal changes. Due to the size of the endoscopes it was mainly used in the gastrointestinal tract so far. First investigations on head and neck carcinoma described the oropharyngeal application. The further miniaturization of the laser probe now allows for endonasal application and thus first experiences with the investigation of endonasal neoplasms. Based on the malignancy criteria validated in the oropharynx, it will now be investigated whether these can be transferred in a similar way to endonasal mucosa.

Methods We used p-CLE (Cellvizio®, Paris, France) with intravenous fluorescein staining in functional endoscopic sinus surgery in patients with nasal polyposis, inverted papilloma and different malignoma of the paranasal sinuses and compared cellular visualization of pathological changes to those of healthy mucosa.

Conclusions p-CLE allows for endonasal use and application of morphological criteria of malignancy in analogy to classical histological examination. The method also allows for assessment based on additional criteria resulting from the altered kinetics of fluorescein used in neoplastic tissue.

Conclusion Our Results suggest that endonasal application of p-CLE represents a valuable extension of the diagnostic repertoire available to date by an additional real-time analysis of nasal mucosa. This is of particular value in surgically challenging anatomical areas such as the paranasal sinus system.

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Publication History

Article published online:
10 June 2020