Reliability of office-based narrow-band imaging-guided flexible laryngoscopic tissue samplings.
OBJECTIVES/HYPOTHESIS
Direct suspension laryngoscopic biopsy performed under general anesthesia is the conventional management for obtaining pathological diagnosis for neoplasms of the larynx, oropharynx, and hypopharynx. Since the development of distal chip laryngoscopy and digital imaging systems, transnasal flexible laryngoscopy tissue sampling has gained popularity as an office-based procedure. Additional assessment with narrow-band imaging (NBI) can help to increase the diagnostic yield. The aim of the study was to evaluate the accuracy, sensitivity, and specificity of a novel diagnostic tool: office-based NBI (OB-NBI) flexible laryngoscopic tissue sampling.


STUDY DESIGN
Retrospective chart review performed in a tertiary referral medical center in Taiwan.


METHODS
From January 2010 to February 2013, 90 consecutive patients received OB-NBI biopsies. The accuracies of the OB-NBI biopsies were compared among locations, tumor sizes, head and neck cancer histories, and other factors.


RESULTS
All patients had completed the procedure without life-threatening complications. The overall sensitivity and specificity were 97.2% and 100%, respectively, with a diagnostic accuracy of 98.9%. Accuracy was not affected by tumor size, location, learning curves, or previous head and neck cancer history.


CONCLUSIONS
We present an integrated technique that merges the safety and versatility of flexible laryngoscopy with the diagnostic power of NBI to produce a promising method of high accuracy and minimal morbidity.


LEVEL OF EVIDENCE
4 Laryngoscope, 126:2764-2769, 2016.
['Chang|Catherine|C|', 'Lin|Wan-Ni|WN|', 'Hsin|Li-Jen|LJ|', 'Lee|Li-Ang|LA|', 'Lin|Chien-Yu|CY|', 'Li|Hsueh-Yu|HY|', 'Liao|Chun-Ta|CT|', 'Fang|Tuan-Jen|TJ|']
D000368:Aged D000369:Aged, 80 and over D001706:Biopsy D005260:Female D006801:Humans D007828:Laryngoscopy D007830:Larynx D008297:Male D008875:Middle Aged D062048:Narrow Band Imaging D010039:Otorhinolaryngologic Neoplasms D010614:Pharynx D015203:Reproducibility of Results D012189:Retrospective Studies D012680:Sensitivity and Specificity
flexible laryngoscopy narrow-band imaging Office biopsy