Article Text

  1. J. M. Ridgway1,2,
  2. S. Guo2,
  3. D. Vokes2,
  4. J. Perez2,
  5. J. Su2,
  6. W. B. Armstrong1,
  7. T. Shibuya1,
  8. R. L. Crumley1,
  9. Z. Chen2,
  10. B J.F. Wong1,2
  1. 1Department of Otolaryngology- Head and Neck Surgery, University of California, Irvine
  2. 2Beckman Laser Institute Irvine, University of California, Irvine


Introduction Optical coherence tomography (OCT) is a noncontact, noninvasive diagnostic modality that combines broadband light source and interferometry to produce high-resolution cross-sectional images in tissue. OCT is analogous to B-scan ultrasound with the exception that light, instead of sound waves, is used to obtain high-resolution images (8-20 μm). OCT may have significant impact in disorders of the aerodigestive tract because of the capacity to produce high-resolution images of various tissue microstructures.

Objectives The results of 15 pediatric patients undergoing operative endoscopy and optical coherence tomography were reviewed.

Materials and Methods In all patients, operative endoscopy of the aerodigestive tract was performed alongside OCT imaging. Images were classified in relation to anatomic sites within the oral cavity, oropharynx, and hypopharynx regions. Specialized structures of the larynx were further characterized in relation to the supraglottic, glottic, and subglottic spaces. The mucosal epithelium, lamina propria, and unique tissue microstructures were visualized and measured. Direct comparison of OCT images to histology was performed when possible.

Results Normal tissue microstructures identified included an overlying keratin layer, papillae, ducts, glands, and blood vessels. Additionally, differences in collagen and elastin density were noted in areas of known biologic variation. Regions of pathology studied include mature scar, granulation tissue, mucous cysts, edema, and papillomatosis. OCT imaging, as related to each pathologic process analyzed, revealed zones of normal, altered, and ablated tissue microstructures.

Conclusions A noncontact technique used to obtain high-resolution cross-sectional images of the tissue microstructures would be of considerable value in the characterization of aerodigestive pathology without the need for tissue biopsy. The data obtained in this pilot research offer a template of tissue characterization in a patient population with noted disorders including, but not limited to, acquired laryngeal stenosis, vascular rings, cysts, laryngeal clefts, hemangiomas, tracheomalacia, recurrent respiratory papillomatosis, croup, and trachitis.

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