J Appl Biomed 21:107-112, 2023 | DOI: 10.32725/jab.2023.015

The importance of preoperative and perioperative Narrow Band Imaging endoscopy in the diagnosis of pre-tumor and tumor lesions of the larynx

Tomáš Filipovský^{1, 2}, David Kalfeřt^{3, 4}, Eva Lukavcová¹, Šárka Zavázalová^{1, 2}, Jiří Hložek^{1, 2}, Daniel Kovář^{1, 2}, Jaromír Astl^{1, 2}, Richard Holý^{1, 2}

¹ Military University Hospital Prague, Department of Otorhinolaryngology and Maxillofacial Surgery, Prague, Czech Republic

² Charles University, Third Faculty of Medicine, Prague, Czech Republic

³ Motol University Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Prague, Czech Republic

⁴ Charles University, First Faculty of Medicine, Prague, Czech Republic

Introduction: Narrow band imaging (NBI) is an endoscopic imaging method intended for the diagnosis of mucosal lesions of the larynx that are not visible in white-light endoscopy, but are typical of pre-tumor and tumor lesions of the larynx. The purpose of the study: To compare preoperative/perioperative white light endoscopy and NBI endoscopy with the results of histopathological examinations in pre-tumor and tumor lesions of the larynx.

Methods: A prospective study, over a period of five years (5/2018-5/2023), included 87 patients with laryngeal lesions aged 24-80 years. We evaluated preoperative/ perioperative white light and NBI endoscopy, established a working prehistological diagnosis, and compared this with the definitive histopathological results of laryngeal biopsies.

Results: In relation to the definitive histology score, a statistically significant correlation was found between the evaluation of the finding and the definitive histology for preoperative and perioperative white light endoscopy and NBI endoscopy (p < 0.001). Both methods showed higher precision when used perioperatively.

Conclusion: NBI endoscopy is an optical method that allows us to improve the diagnosis of laryngeal lesions, perform a controlled perioperative biopsy, and refine the surgical scope. The NBI endoscopy is a suitable method for the diagnosis of early cancerous lesions of the larynx. The use of preoperative/perioperative NBI endoscopy allowed us to achieve a high level of agreement correlation (p < 0.001) between the prehistological working diagnosis and the final histopathological result. The NBI method proves its application in the diagnosis of pre-tumor and tumor lesions of the larynx.

Keywords: Endoscopy; Histopathological results; Laryngeal tumor; Narrow band imaging; Perioperative endoscopy; Preoperative endoscopy

Grants and funding:

Our prospective study was approved by the Ethics Committee of the Military University Hospital Prague – Reference Number 108/17-29/2022. All patients signed an informed consent form. This research was funded by Project MO 1012 of the Ministry of Defence of the Czech Republic and by the Cooperation Program, research area SURG., Charles University, Czech Republic.

Conflicts of interest:

The authors have no conflict of interest to declare.

Received: August 16, 2023; Revised: August 31, 2023; Accepted: September 13, 2023; Published: September 22, 2023  Show citation