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

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dc.citation.firstpage1016
dc.citation.issueNumber4
dc.citation.journalTitleThe Laryngoscope
dc.citation.lastpage1020
dc.citation.volumeNumber123
dc.contributor.authorLevy, Lauren L.
dc.contributor.authorJiang, Nancy
dc.contributor.authorSmouha, Eric
dc.contributor.authorRichards-Kortum, Rebecca
dc.contributor.authorSikora, Andrew G.
dc.date.accessioned2013-03-18T21:09:49Z
dc.date.available2014-03-19T05:10:04Z
dc.date.issued2013
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.
dc.embargo.terms1 year
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.23710
dc.identifier.urihttps://hdl.handle.net/1911/70706
dc.language.isoeng
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.keywordCholesteatoma
dc.subject.keywordkeratin
dc.subject.keywordoptical imaging
dc.subject.keywordotology
dc.subject.keywordhigh-resolution microendoscopy
dc.titleOptical Imaging With a High-Resolution Microendoscope to Identify Cholesteatoma of the Middle Ear
dc.typeJournal article
dc.type.dcmiText
dc.type.publicationpublisher version
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