Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept

Introduction Probe-based confocal laser endomicroscopy (p-CLE) is a method for real-time in vivo visualization of mucosal changes on a cellular level. 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...

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Autores principales:	Nina Wenda, Ralf Kiesslich, Jan Gosepath
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Revinter Publicações Ltda. 2021
Materias:	confocal laser endomicroscopy endonasal endoscopic surgery endonasal squamous cell carcinoma Medicine R Otorhinolaryngology RF1-547
Acceso en línea:	https://doaj.org/article/b3bd79e513244efa85038136408513e8
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spelling	oai:doaj.org-article:b3bd79e513244efa85038136408513e82021-11-06T00:16:12ZTechnical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept1809-97771809-486410.1055/s-0041-1724091https://doaj.org/article/b3bd79e513244efa85038136408513e82021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1724091https://doaj.org/toc/1809-9777https://doaj.org/toc/1809-4864Introduction Probe-based confocal laser endomicroscopy (p-CLE) is a method for real-time in vivo visualization of mucosal changes on a cellular level. 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 endonasal application and, thus, first experiences with the investigation of endonasal neoplasms. Objectives The aim of the present investigation is to elucidate, based on the morphological criteria validated in the oropharynx, whether these criteria be transferred in a similar way to the endonasal mucosa. Methods We conducted p-CLE (Cellvizio, Paris, France) with intravenous fluorescein staining in endoscopic sinus surgery in a patient with sinonasal inverted papilloma and a histologically confirmed squamous cell carcinoma. We compared the cellular visualization of pathological changes with those of healthy mucosa in the same specimen, and also with our former findings in the oropharynx. Results Endonasal p-CLE proved to be quite feasible in the surgical setting, and the transfer of malignancy criteria in analogy to histological examination could be optically retraced. Furthermore, additional criteria for tissue dignity assessment were obtained. 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 the nasal mucosa. This is of particular value in surgically challenging anatomical areas such as the paranasal sinuses. Further investigation and validation will be necessary.Nina WendaRalf KiesslichJan GosepathThieme Revinter Publicações Ltda.articleconfocal laser endomicroscopyendonasal endoscopic surgeryendonasal squamous cell carcinomaMedicineROtorhinolaryngologyRF1-547ENInternational Archives of Otorhinolaryngology (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	confocal laser endomicroscopy endonasal endoscopic surgery endonasal squamous cell carcinoma Medicine R Otorhinolaryngology RF1-547
spellingShingle	confocal laser endomicroscopy endonasal endoscopic surgery endonasal squamous cell carcinoma Medicine R Otorhinolaryngology RF1-547 Nina Wenda Ralf Kiesslich Jan Gosepath Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept
description	Introduction Probe-based confocal laser endomicroscopy (p-CLE) is a method for real-time in vivo visualization of mucosal changes on a cellular level. 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 endonasal application and, thus, first experiences with the investigation of endonasal neoplasms. Objectives The aim of the present investigation is to elucidate, based on the morphological criteria validated in the oropharynx, whether these criteria be transferred in a similar way to the endonasal mucosa. Methods We conducted p-CLE (Cellvizio, Paris, France) with intravenous fluorescein staining in endoscopic sinus surgery in a patient with sinonasal inverted papilloma and a histologically confirmed squamous cell carcinoma. We compared the cellular visualization of pathological changes with those of healthy mucosa in the same specimen, and also with our former findings in the oropharynx. Results Endonasal p-CLE proved to be quite feasible in the surgical setting, and the transfer of malignancy criteria in analogy to histological examination could be optically retraced. Furthermore, additional criteria for tissue dignity assessment were obtained. 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 the nasal mucosa. This is of particular value in surgically challenging anatomical areas such as the paranasal sinuses. Further investigation and validation will be necessary.
format	article
author	Nina Wenda Ralf Kiesslich Jan Gosepath
author_facet	Nina Wenda Ralf Kiesslich Jan Gosepath
author_sort	Nina Wenda
title	Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept
title_short	Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept
title_full	Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept
title_fullStr	Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept
title_full_unstemmed	Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept
title_sort	technical note: first use of endonasal confocal laser endomicroscopy – feasibility and proof of concept
publisher	Thieme Revinter Publicações Ltda.
publishDate	2021
url	https://doaj.org/article/b3bd79e513244efa85038136408513e8
work_keys_str_mv	AT ninawenda technicalnotefirstuseofendonasalconfocallaserendomicroscopyfeasibilityandproofofconcept AT ralfkiesslich technicalnotefirstuseofendonasalconfocallaserendomicroscopyfeasibilityandproofofconcept AT jangosepath technicalnotefirstuseofendonasalconfocallaserendomicroscopyfeasibilityandproofofconcept
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Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy – Feasibility and Proof of Concept

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