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Narrow band imaging is a new technique in visualization of recurrent respiratory papillomatosis

Authors

  • Robin E. A. Tjon Pian Gi MD,

    Corresponding author
    1. Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
    • Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, the Netherlands
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  • Gyorgy B. Halmos MD, PhD,

    1. Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
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  • Bettien M. van Hemel MD,

    1. Department of Pathology, University of Groningen, University Medical Center Groningen, the Netherlands
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  • Edwin R. van den Heuvel MSc, PhD,

    1. Department of Epidemiology, University of Groningen, University Medical Center Groningen, the Netherlands
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  • Bernard F. A. M. van der Laan MD, PhD,

    1. Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
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  • Boudewijn E. C. Plaat MD, PhD,

    1. Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
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  • Frederik G. Dikkers MD, PhD

    1. Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
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  • Presented in part at the 219th Meeting of the Netherlands Society for Otorhinolaryngology, Head and Neck Surgery, Groningen, the Netherlands, November 17–18, 2011.

  • Medical equipment was supplied by Olympus Netherlands during the period of this study. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

Recurrent respiratory papillomatosis (RRP) is a rare, benign, wart-like disease for which no curative treatment exists. The goal of treatment is total surgical removal of the epithelial lesions to keep the airway open and the voice sufficient. Therefore, it is essential to visualize all papillomatous lesions. The present study aims to evaluate the sensitivity of additional use of narrow band imaging (NBI) in detecting RRP during microlaryngoscopy.

Study Design:

Prospective study.

Methods:

Between January 2011 and July 2011, patients with RRP underwent systematic inspection during microlaryngoscopy using conventional white light (WL) immediately followed by inspection with NBI. Consensus was achieved about the number of lesions and number of RRP suspect lesions. All lesions were subsequently excised and sent for histopathological examination.

Results:

Eighty-six excisional biopsies were taken in 24 microlaryngoscopies performed in 14 RRP patients. Eleven out of the 13 additional biopsies taken, induced by the second inspection with NBI, proved to be papillomata after histopathological examination. The sensitivity increased from 80% with WL up to 97% with WL + NBI (P < .01), whereas the specificity remained poor (32% and 28%, respectively).

Conclusions:

NBI is an additional diagnostic tool in increasing the sensitivity of visualizing papillomata during microlaryngoscopy. Laryngoscope, 2012

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