Optical Imaging With a High-Resolution Microendoscope to Identify Cholesteatoma of the Middle Ear

dc.citation.firstpage1016en_US
dc.citation.issueNumber4en_US
dc.citation.journalTitleThe Laryngoscopeen_US
dc.citation.lastpage1020en_US
dc.citation.volumeNumber123en_US
dc.contributor.authorLevy, Lauren L.en_US
dc.contributor.authorJiang, Nancyen_US
dc.contributor.authorSmouha, Ericen_US
dc.contributor.authorRichards-Kortum, Rebeccaen_US
dc.contributor.authorSikora, Andrew G.en_US
dc.date.accessioned2013-03-18T21:09:49Z
dc.date.available2014-03-19T05:10:04Z
dc.date.issued2013en_US
dc.description.abstractObjectives/Hypothesis: High-resolution optical imaging is an imaging modality that allows visualization of structural changes in epithelial tissue in real time. Our prior studies using contrast-enhanced microendoscopy to image squamous cell carcinoma in the head and neck demonstrated that the contrast agent, proflavine, has high affinity for keratinized tissue. Thus, high-resolution microendoscopy with proflavine provides a potential mechanism to identify ectopic keratin production, such as that associated with cholesteatoma formation, and distinguish between uninvolved mucosa and residual keratin at the time of surgery. Study Design: Ex vivo imaging of histopathologically confirmed samples of cholesteatoma and uninvolved middle ear epithelium. Methods: Seven separate specimens collected from patients who underwent surgical treatment for cholesteatoma were imaged ex vivo with the fiberoptic endoscope after surface staining with proflavine. Following imaging, the specimens were submitted for hematoxylin and eosin staining to allow histopathological correlation. Results: Cholesteatoma and surrounding middle ear epithelium have distinct imaging characteristics. Keratin-bearing areas of cholesteatoma lack nuclei and appear as confluent hyperfluorescence, whereas nuclei are easily visualized in specimens containing normal middle ear epithelium. Hyperfluorescence and loss of cellular detail is the imaging hallmark of keratin, allowing for discrimination of cholesteatoma from normal middle ear epithelium. Conclusions: This study demonstrates the feasibility of high-resolution optical imaging to discriminate cholesteatoma from uninvolved middle ear mucosa based on the unique staining properties of keratin. Use of real-time imaging may facilitate more complete extirpation of cholesteatoma by identifying areas of residual disease.en_US
dc.embargo.terms1 yearen_US
dc.identifier.citationLevy, Lauren L., Jiang, Nancy, Smouha, Eric, et al.. "Optical Imaging With a High-Resolution Microendoscope to Identify Cholesteatoma of the Middle Ear." <i>The Laryngoscope,</i> 123, no. 4 (2013) Wiley: 1016-1020. http://dx.doi.org/10.1002/lary.23710.
dc.identifier.doihttp://dx.doi.org/10.1002/lary.23710en_US
dc.identifier.urihttps://hdl.handle.net/1911/70706
dc.language.isoengen_US
dc.publisherWiley
dc.rightsArticle is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
dc.subject.keywordCholesteatomaen_US
dc.subject.keywordkeratinen_US
dc.subject.keywordoptical imagingen_US
dc.subject.keywordotologyen_US
dc.subject.keywordhigh-resolution microendoscopyen_US
dc.titleOptical Imaging With a High-Resolution Microendoscope to Identify Cholesteatoma of the Middle Earen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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