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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(03): e396-e400
DOI: 10.1055/s-0041-1724091
Original Research

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

Authors

  • Nina Wenda 

    1   Department for Otolaryngology, Head and Neck Surgery, Schmidt Kliniken Wiesbaden, Wiesbaden, Germany

  • Ralf Kiesslich 

    2   Department for Gastroenterology, Schmidt Kliniken Wiesbaden, Wiesbaden, Germany

  • Jan Gosepath 

    1   Department for Otolaryngology, Head and Neck Surgery, Schmidt Kliniken Wiesbaden, Wiesbaden, Germany

Funding Tumorstiftung Kopf-Hals Wiesbaden, (Grant / Award Number: 15.000 €)
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Abstract

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.

Keywords

confocal laser endomicroscopy - endonasal endoscopic surgery - endonasal squamous cell carcinoma


Publication History

Received: 28 August 2020

Accepted: 21 November 2020

Article published online:
05 November 2021

© 2021. 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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