Effectiveness of narrow band imaging in the detection of premalignant and malignant lesions of the larynx: Validation of a new endoscopic clinical classification

Abstract

The NBI ability to detect changes in the mucosal microvasculature can be useful for distinguishing nonmalignant from malignant lesions. An internationally accepted NBI-endoscopic classification may contribute to the further definition of the diagnostic validity of this technique.

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

“…protuberant or ulcerative lesions covered with necrotic tissue, or leukoplakia of unknown type); or (3) benign (types I to IV) (135). In the literature, there exist only a few publications on the exclusive use of NBI in laryngology (135)(136)(137)(138)(139)(140)(141)(142). However, several studies assessed the value of NBI in the head and neck also including the larynx (132,137,(143)(144)(145)(146)(147)(148).…”

“…Nevertheless, NBI is able to better specify their exact extension and show infiltration of neighboring structures. Additionally, NBI might detect second primaries or field cancerization in these patients (138) and it presents a potential advantage in post-treatment surveillance (247)(248)(249). Compared to AFE, NBI endoscopy has the advantage of being able to obtain the same information using both a videoendoscope coupled with a HDTV camera and rigid telescopes (137).…”

Subtotal supracricoid laryngectomy: changing in indications, surgical techniques and use of new surgical devices

“…A comparison among original indications to SCPL [3][4][5][6][7][8] and recent literature results [9,15,16], supports a clear development and more extended use of this procedure [33][34][35][36][37]. Progression in CAT scan and MRI [10,11], as well new diagnostic endoscopic laryngeal procedures [12][13][14], allow a millimetric evaluation of tumor extension with a more accurate treatment planning, rendering the surgeon more confident in SCPL option. Accordingly, here we reported a larger use of SCPL in older patients (p = 0.02), T3 staged patients (p = 0.02) and for CHEP than for CHP (p = 0.001).…”

“…All of these surgeons proposed supracricoid partial laryngectomy as valid surgical alternative to total laryngectomy in elective T1 and T2 laryngeal cancer patients, describing it as a technique able to ensure recovery from the disease and laryngeal function preservation together. So far, surgical indications have been changed and extended to more advanced staged cancers [1,4,9] because of the improvement of diagnostic technologies such as CAT scan and MRI [10,11], a more precise stage of the disease by endoscopic fiberoptic together with fluorescence or narrow banding imaging (NBI) exams [12][13][14], as well as because of the advent of new surgical devices [15] which allowed the improvement of the intraoperative management of the operation and the surgical technique as well. All of these changes, together with the help of frozen section analysis in the intraoperative control of resection margins [16,17], have determined a radical turn in the management of these laryngeal cancer patients during the last 40 years, furthermore, with the new concept that recurrent irradiated cancer has to be treated as a primitive one, with no worsening in staging status and surgical indication, with no absolute contraindication for SCPL [18][19][20].…”

Use of Narrow Spectral Endoscopy Method in Diagnostics of Malignant Larynx Diseases: Literature Review Nand Clinical Obsevrations

“…В еще одном исследовании также приводятся обнадеживающие дан-ные о диагностической эффективно-сти метода NBI-эндоскопии. Чувстви-тельность, специфичность и точность составили 97,4, 84,6, 92,7% соответ-ственно [13].…”