Endolaryngeal high-frequency ultrasound

Arens, Christoph; Eistert, Bernd; Glanz, H.; Waas, Wolfgang

doi:10.1007/s004050050052

Cited by 36 publications

(21 citation statements)

References 13 publications

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“…In the literature, there exist only a few publications on endosonography of the larynx. Most of them were purely experimental studies on cadaver specimens (210,211,213). staging laryngeal cancer.…”

mentioning

confidence: 99%

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

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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Abstract.Background: Multi-step cancerogenesis guides laryngeal cancer onset and it includes a wide variety of pre-cancerous lesions that are macroscopically challenging to identify and distinguish from initial cancerous foci. Since the treatment of laryngeal cancer and its precursor lesions has a great impact on important laryngeal basic functions, early detection and preoperative assessment are important for a curative and function-preserving therapy. Nowadays, despite the high number of more advanced diagnostic techniques and methods, unfortunately, it is not uncommon for different clinicians to use different nomenclature or to identify different stage for the same laryngeal lesion. From these observations, it is obvious that an instrument offering the possibility to detect precancerous lesions, early cancerous lesions, and satellite foci or second primaries would be the key to improving management and outcome in laryngeal patients. Object. Different modalities of diagnostic techniques of laryngeal lesions exist. Rather than difference between benign and obvious malignant diseases, more difficult is to detect the presence of precancerous epithelial alterations. Not all tests achieve the same diagnostic accuracy, hence this meta-analysis of literature aimed to synthesize the validity of each single diagnostic technique in identifying and staging laryngeal disease. Methods: A systematic review of literature was led searching for articles mentioning the following terms including their various combinations to maximize the yield: larynx, laryngeal precancerous lesions, laryngeal cancer, white light (WL) endoscopy, stroboscopy, contact endoscopy (CE), autofluorescence (AF), ultrasound (US), narrow band imaging (NBI), computed axial tomography (CAT), magnetic resonance imaging (MRI), positron emission tomography (PET), CAT/PET. Then, a quantitative analysis was carried on for paper published after 2005 onward, reporting a minumun series of 10 patients each study, declaring sensitivity and specificity of each diagnostic system. Results: The search identified 7215 publications, of which 3616 published after 2005, with a final results of a total of 214 articles stratified and included by our selection criteria. 42 out of 214 articles were selected for quantitative synthesis. 25 out of 41 studies had a quality score of ≥ 6 (good), 16 presented a score between 4 and 5 (fair). While objections can be raised about the pooling of different diagnostic procedures under the same group and the high level of heterogeneity in the meta-analyses, the inclusion of over 4400 laryngeal lesions makes the results fairly robust. Conclusions: A comprehensive overview of the most recent advances in laryngeal imaging technology combined with all of the information needed to interpret findings and successfully manage patients with voice disorders can be found herein. With these data, clinicians can riskstratify patients and select proper examination modalities in order to provide appropriate care. Moreover, study limitations, together with p...

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confidence: 99%

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

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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“…3 The location of the orotracheal tube and anatomical structures such as the cricoid and thyroid cartilage are very helpful landmarks within the larynx. 2 Hence, orientation during endolaryngeal ultrasound is possible either by endoscopic control or through direct observation of the sonographic image on the monitor.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, a transcervical approach does not generally allow complete sonographic evaluation of the larynx, due to ossification and intraluminal air. 2 For this reason, computed tomography (CT) and magnetic resonance imaging (MRI) are used to supplement microlaryngoscopy as additional diagnostic tools in the investigation of more extensive laryngeal lesions. 3 Endoscopic versions of ultrasound technology have been developed and successfully applied in the fields of cardiology and gastroenterology.…”

Section: Introductionmentioning

confidence: 99%

Technique of high-frequency endolaryngeal ultrasound

Kraft

Arens

2008

J. Laryngol. Otol.

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Objective: We describe in detail the technique of in vivo endolaryngeal ultrasound during microlaryngoscopy, offering a number of practical suggestions which may be of use, especially to the otolaryngologist.Methods: Endosonography is a non-invasive imaging technology usually applied for the assessment of local tumour growth and regional lymph node metastases in the digestive tract.Conclusions: Due to a penetrating depth of up to 25 mm and a high tissue resolution, endosonography also qualifies for use in the larynx. The technique may have a potentially important role in the intra-and post-operative investigation of laryngeal lesions bigger than 3 mm.Key words: Ultrasound; Imaging; Larynx Neoplasm; Laryngology; Laryngoscopy Introduction High-frequency ultrasound is a common imaging modality used to examine the thyroid, salivary glands, lymph nodes, and soft tissues in the head and neck. 1 However, a transcervical approach does not generally allow complete sonographic evaluation of the larynx, due to ossification and intraluminal air. 2 For this reason, computed tomography (CT) and magnetic resonance imaging (MRI) are used to supplement microlaryngoscopy as additional diagnostic tools in the investigation of more extensive laryngeal lesions. 3 Endoscopic versions of ultrasound technology have been developed and successfully applied in the fields of cardiology and gastroenterology. 4,5 Recent investigations of laryngeal endosonography have demonstrated a penetrating depth of 10 to 25 mm (depending on the applied frequency) and a high tissue resolution. 6 -9 Therefore, endolaryngeal ultrasound may be able to predict the exact extension of a laryngeal tumour before surgery is performed, and to assist in finding the best therapeutic solution for the patient. 3 Thus, this non-invasive method could represent an additional diagnostic tool in the field of laryngology.There is currently no precise description in the literature of how to perform in vivo endolaryngeal ultrasound imaging of the larynx. Therefore, the objective of the present study was to fill this gap, and also to offer a number of practical suggestions on the use of this technology.

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“…Die Entwicklung von klein dimensionierten flexiblen Hochfrequenzultraschallkathetern mit einer höheren Auflösung ermöglicht eine verbesserte endolaryngeale Anwendung [5,6,7,43,45] Normales Epithel stellt sich in der EMI echoarm dar und weist je nach Lokalisation eine unterschiedliche Dicke auf. Diese beträgt im Bereich der Stimmlippe eine Epitheldicke von 50-100 μm.…”

Section: Endosonographie Endoskopischer Hochfrequenzultraschallunclassified

Fortschritte der endoskopischen Diagnostik von Dysplasien und Karzinomen des Larynx

Arens

Vorwerk

Just

et al. 2012

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Das Larynxkarzinom zählt zu den häufigsten malignen Tumoren des oberen Aerodigestivtrakts. Lage, Ausdehnung und Differenzierung des Tumors haben entscheidenden Einfluss auf die Prognose. Plattenepitheldysplasien können in ein infiltrierendes Karzinom übergehen, wobei mittel-und höhergradige Dysplasien obligate Präkanzerosen darstellen [41]. Die operative Therapie des Kehlkopfkarzinoms und seiner Vorstufen stellt an den Larynxchirurgen hohe Ansprüche. Neben dem kurativen Aspekt einer Behandlung sollte die Erhaltung der grundlegenden Kehlkopffunktionen wie Atmung, Stimmbildung und Aspirationsschutz beim Schluckakt berücksichtigt werden. Um diese Erwartungen zu erfüllen, verbindet das Prinzip der Phonochirurgie des Kehlkopfs onkologische mit funktionserhaltenden Anforderungen unter Verwendung fortschrittlicher mikrochirurgisch-laryngoskopischer Techniken. Daher ist eine genaue prä-und perioperative Diagnostik einer laryngealen Veränderung entscheidend für das erforderliche Ausmaß der Therapie. Die präoperative Diagnostik beim Larynxkarzinom erfolgt üblicherweise zunächst ambulant mittels indirekter Laryngoskopie. Die Erkennung und Einschätzung tumorverdächtiger Läsionen ist hierbei wesentlich von der Erfahrung des Untersuchers abhängig. In den vergangenen 2 Dekaden gab es verschiedene Anstrengungen, um neu entwickelte endoskopisch bildgebende Verfahren aus dem Forschungslabor in den Klinikalltag zu übertragen [7].Die Mikrolaryngoskopie (MLS) ermöglicht neben der Visualisierung tumoröser Läsionen die Palpation zur verbesserten Einschätzung pathologischer Veränderungen [40]. Trotzdem fällt es auch dem erfahrenen Laryngologen gelegentlich schwer, die genaue Ausdehnung und Tiefeninfiltration von Tumoren im Rahmen der MLS zu beurteilen. Hierbei wä-re es wünschenswert, genau zwischen gesunder Schleimhaut, Dysplasie und invasivem Karzinom unterscheiden zu kön-nen. Daher wurden verschiedene endoskopisch bildgebende Verfahren (EBV) entwickelt, um sich dem Ziel der "optischen Biopsie" anzunähern.Ziel der Arbeit ist es, die verschiedenen EBV vorzustellen und deren gegenwärti-gen Stellenwert in der Diagnostik näher zu beleuchten.In der genaueren Betrachtung der verschiedenen endoskopischen Techniken ist es notwendig, die unterschiedlichen Qualitäten und Möglichkeiten der Verfahren zu kennen. Wir unterscheiden zwischen EBV, die sich in vertikale und horizontale sowie zelluläre Ausbreitungsdiagnostik differenzieren, wobei sich die konfokale Endomikroskopie (KOM) in 2 Gruppen einordnen ließe.

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Endolaryngeal high-frequency ultrasound

Cited by 36 publications

References 13 publications

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

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

Technique of high-frequency endolaryngeal ultrasound

Fortschritte der endoskopischen Diagnostik von Dysplasien und Karzinomen des Larynx

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