Intraoperative application possibilities of probe-based confocal laser endomicroscopy

Introduction Confocal laser endomicroscopy (CLE) offers the possibility for the head and neck surgeon to detect intercellular spaces in vivo with up to 1000-fold magnification power. Objective of this multimedia presentation is to give an overview on current applications of probe-based CLE (pCLE) in the diagnosis of squamous cell carcinoma of the head and neck region using intraoperative case studies.

Material and Methods Video recordings of examinations using pCLE were taken in 4k resolution. As contrast agent we used 5 ml fluorescein 10%. The range of cases include panendoscopies or microlaryngoscopies of suspicious mucosal areas as well as in surgical excision of laryngeal, pharyngeal and oral malignancies.

Results pCLE can be used easily and flexibly in various intraoperative situations. The fluorescein administered intraoperatively is well tolerated and allows image acquisition with sufficient contrast quality for about 10 minutes.

Healthy mucosa is characterized by regular cellular size, shape and architecture. In carcinomas, CLE allows visualisation of irregular cellular architecture, atypical vasculature and poorly defined cellular margins.

Conclusion/ Discussion Accurate differentiation between normal mucosa, benign and malignant mucosal changes is of particular importance in early tumor detection. Furthermore, CLE can significantly contribute to improve tumour follow-up monitoring for possible local recurrence and reduce the risk caused by unnecessary biopsies. An additional motivation for non-invasive in vivo diagnostics is the more precise definition of resection margins and represents a novel approach on image-guided surgery.

Deutsche Forschungsgemeinschaft

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Artikel online veröffentlicht:
24. Mai 2022