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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2021; 25(03): e471-e478
DOI: 10.1055/s-0040-1719119
Systematic Review

The Impact of Narrow-band Imaging on the Pre- and Intra- operative Assessments of Neoplastic and Preneoplastic Laryngeal Lesions. A Systematic Review

Carmelo Saraniti 
1   Department of Biomedicine, Neurosciences and Advanced Diagnostics, ENT Clinic, Università degli Studi di Palermo, Palermo, Italy
,
Enzo Chianetta 
1   Department of Biomedicine, Neurosciences and Advanced Diagnostics, ENT Clinic, Università degli Studi di Palermo, Palermo, Italy
,
Giuseppe Greco 
1   Department of Biomedicine, Neurosciences and Advanced Diagnostics, ENT Clinic, Università degli Studi di Palermo, Palermo, Italy
,
Norhafiza Mat Lazim 
2   Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
,
Barbara Verro 
1   Department of Biomedicine, Neurosciences and Advanced Diagnostics, ENT Clinic, Università degli Studi di Palermo, Palermo, Italy
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Abstract

Introduction Narrow-band imaging is an endoscopic diagnostic tool that, focusing on superficial vascular changes, is useful to detect suspicious laryngeal lesions, enabling their complete excision with safe and tailored resection margins.

Objectives To analyze the applications and benefits of narrow-band imaging in detecting premalignant and malignant laryngeal lesions through a comparison with white-light endoscopy.

Data Synthesis A literature search was performed in the PubMed, Scopus and Web of Science databases using strict keywords. Then, two authors independently analyzed the articles, read the titles and abstracts, and read completely only the relevant studies according to certain eligibility criteria. In total, 14 articles have been included in the present review; the sensitivity, specificity, positive and negative predictive values, and accuracy of pre- and/or intraoperative narrow-band imaging were analyzed. The analysis showed that narrow-band imaging is better than white-light endoscopy in terms of sensitivity, specificity, positive and negative predictive values, and accuracy regarding the ability to identify cancer and/or precancerous laryngeal lesions. Moreover, the intraoperative performance of narrow-band imaging resulted more effective than the in-office performance.

Conclusion Narrow-band imaging is an effective diagnostic tool to detect premalignant and malignant laryngeal lesions and to define proper resection margins. Moreover, narrow-band imaging is useful in cases of leukoplakia that may cover a possible malignant lesion and that cannot be easily assessed with white-light endoscopy. Finally, a shared, simple and practical classification of laryngeal lesions, such as that of the European Laryngological Society, is required to identify a shared lesion management strategy.

Key Points

  • Narrow-band imaging is useful in detecting suspicious laryngeal lesions and proper resection margins showing intraepithelial papillary capillary loops (IPCLs) that are considered a main cancer feature.

  • Narrow-band imaging is used both pre- and intraoperatively, but it provides more precise information if used during surgery.

  • Compared with white-light endoscopy, narrow-band imaging enables a better assessment of the lesions covered by a thick white plaque (such as in cases of leukoplakia)

  • The classification of the European Laryngological Society is the simplest and the most practical for the identification of various laryngeal lesions compared with other classifications.

Keywords

narrow-band imaging - early diagnosis - larynx cancer


Publication History

Received: 05 June 2020

Accepted: 27 September 2020

Article published online:
30 November 2020

© 2020. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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