Wenda Nina, Kiesslich Ralf, Gosepath Jan
ORL HNS, HELIOS Dr. Horst Schmidt Kliniken Wiesbaden, Germany.
Gastroenterology, HELIOS Dr. Horst Schmidt Kliniken Wiesbaden, Germany.
Laryngorhinootologie. 2021 Oct;100(10):818-823. doi: 10.1055/a-1418-9175. Epub 2021 Mar 26.
Confocal laser endomicroscopy (CLE) is a method for real-time in vivo visualization of mucosal changes on a cellular level. First investigations on head and neck carcinoma described the oropharyngeal application. The aim of this investigation is to elucidate, based on the criteria validated in the oropharynx, whether these can be transferred to endonasal mucosa.
CLE was performed with intravenous fluorescein staining in endoscopic sinus surgery in one patient with sinonasal inverted papilloma and another with squamous cell carcinoma. We compared cellular visualization of pathological changes to those of healthy mucosa in the same specimen as well to our former findings in the oropharynx.
Endonasal CLE proved to be well 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.
Our results suggest that endonasal CLE represents a valuable extension of the diagnostic repertoire available to date by an additional real-time analysis of nasal mucosa. This is of particular value in surgically challenging anatomical areas such as the paranasal sinuses. Further investigation and validation will be necessary.
共聚焦激光内镜检查（CLE）是一种在细胞水平对黏膜变化进行实时体内可视化的方法。对头颈部癌的初步研究描述了其在口咽部位的应用。本研究的目的是基于在口咽部验证的标准，阐明这些标准是否可应用于鼻内黏膜。
在一名鼻窦内翻性乳头状瘤患者和另一名鳞状细胞癌患者的内镜鼻窦手术中，采用静脉注射荧光素染色进行CLE检查。我们将同一标本中病理改变的细胞可视化与健康黏膜的细胞可视化进行了比较，并与我们之前在口咽部的研究结果进行了比较。
鼻内CLE在手术环境中被证明是可行的，并且类似于组织学检查的恶性标准的转移可以通过光学追踪。此外，还获得了用于组织尊严评估的其他标准。
我们的结果表明，鼻内CLE通过对鼻黏膜进行额外的实时分析，是对现有诊断方法的有价值补充。这在诸如鼻窦等手术难度较大的解剖区域具有特别的价值。进一步的研究和验证是必要的。
