Abstract

Optical coherence tomography (OCT) and confocal endomicroscopy (CEM) have a well-established potential for early diagnosis of pre-malignant and early malignant lesions of the upper aerodigestive tract mucosa. Additional applications in ENT-diagnostics might facilitate a more widespread use by making the investment into the devices more economic. Both imaging techniques might also provide valuable information in nasal pathologies.

OCT images were generated with a surgical microscope (Möller-Wedel Hi-R 1000) with an integrated high-speed-OCT camera (Optomedical GmbH). For the CEM a Heidelberg Retina tomograph II scanner (Heidelberg Engineering GmbH) was used. Both during sinus surgery in vivo and from removed material ex vivo OCT and CEM images were taken and correlated with histopathological analysis after hematoxylin and eosin staining.

Patients with inverted papillomas and chronic rhinosinusitis (CRS) were evaluated. Inverted papillomas show a variably thick epithelial layer on OCT and densely packed epithelial cells on CEM. They can be clearly distinguished from nasal polyps that show a very thin epithelial layer upon loose subepithelial tissue. In CRS CEM can distinguish areas with intact from areas with destroyed ciliated epithelium by directly visualizing ciliary movement. OCT sometimes showed thin superficial dense structures that might correspond to biofilms.

OCT and CEM might provide valuable information in the follow-up care of patients with inverted papillomas and in diagnostics of CRS.

© 2013 SPIE