Introduction
Narrowband imaging (NBI) is a special endoscopic optical enhancement setting allowing better visualization of mucosal microvasculature compared to white light endoscopy. This study evaluates the validity of NBI using the Ni classification in the detection and differentiation of severe dysplasia (SD) and glottic squamous cell carcinoma (SCC).
Methods
Patients with suspicious vocal cord lesions underwent conventional white light endoscopy followed by clinically indicated biopsy. At the same time, NBI images were obtained and graded independently. Lesions were graded from I to V according to the Ni classification and compared to histopathological findings.
Results
Fifty‐two patients were included in this study (40 SCC and 12 SD). The sensitivity and specificity of NBI in diagnosing laryngeal cancer was 95.0% (CI, 83.9%‐99.4%) and 83.3% (CI, 51.6%‐97.9%), respectively. The negative likelihood ratio was 0.06. Higher Ni grades correlated very strongly with more advanced disease.
Conclusions
NBI using the Ni classification is a sensitive diagnostic tool for the detection and differentiation of early neoplastic and preneoplastic glottic lesions. As higher Ni classification correlates strongly with advanced disease, it serves as a useful adjunct to white light endoscopy in the diagnosis of laryngeal cancer.
Level of Evidence: Level IV.
Background: Antibiotic resistance has become a global health issue with substantial health and economic burdens. Surgical prophylaxis is the main indication for prescribing antibiotics and over 40% of prescriptions are inappropriate. This study aims to assess the antibiotic prescribing practices in Otolaryngology, Head and Neck Surgery in Australia and New Zealand, comparing current practices to national guidelines and current evidence. Methods: A survey was sent to practising Otolaryngologists, Head and Neck Surgeons in Australia and New Zealand. Surgeons were asked to indicate their antibiotic prescribing practises for general and subspecialty procedures.
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