Embed Size (px)
Citation preview
CONTACT ENDOSCOPYPresenter: Surg Lt Cdr Rahul Naga
Moderator: Col S K Singh
04
/07
/20
23
2
Dept o
f EN
T, A
FMC
, Pune
LAYOUT
Introduction Technical details Contact endoscopy of the larynx Contact endoscopy of the nasal cavity Contact endoscopy of the nasopharynx Contact endoscopy of oral cavity and
oropharynx Recent advances References
04
/07
/20
23
3
Dept o
f EN
T, A
FMC
, Pune
INTRODUCTION
Desormeaux, 1865
Jaupitre
Hamou, 1979 micropolyhysteroscopy
L’Estrange et al, 1989
Andrea et al, 1995
04
/07
/20
23
4
Dept o
f EN
T, A
FMC
, Pune
INTRODUCTION
In vivo and in situ observation
Complements biopsy and HPE
Cells migrate towards surface
Assess microscopic structure of entire mucosa
04
/07
/20
23
5
Dept o
f EN
T, A
FMC
, Pune
TECHNICAL DETAILS
Anaesthesia Endoscopes
Karl Storz 7215 AA Karl Storz 7215 BA Karl Storz 8715 AA
04
/07
/20
23
6
Dept o
f EN
T, A
FMC
, Pune
TECHNICAL DETAILS
04
/07
/20
23
7
Dept o
f EN
T, A
FMC
, Pune
TECHNICAL DETAILS
Light source
Magnification
Dye
04
/07
/20
23
8
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
Normal appearance Vocal Cord edge
Squamous cells Polyhedric shape Contigous Nuclei- round, darkly stained Cytoplasm- light blue
Rest of larynx Ciliated epithelium
04
/07
/20
23
9
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
Abnormal appearance
Metaplastic substitution of ciliated epethelium Heavy smokers GERD
04
/07
/20
23
10
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
Chronic Laryngitis Epethelial pattern homogenous Larger nuclei Increased nuclear cytoplasmic ratio
Keratosis Isolated cells without nuclei Large areas of amorphous or laminar structure
04
/07
/20
23
11
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
Leukoplakia
Dysplasia Variations in nuclear size, colour and shape Change in nuclear cytoplasmic ratio Vascular changes
Carcinoma Variable morphology Nuclear heterogeneity
04
/07
/20
23
12
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
Laryngeal papillomata
Typical vascular loops Koilocytes Can aid in more accurate excision Reduced risk of residual or recurrent disease
04
/07
/20
23
13
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
04
/07
/20
23
14
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
04
/07
/20
23
15
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
04
/07
/20
23
16
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
04
/07
/20
23
17
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF LARYNX
04
/07
/20
23
18
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF THE NASAL CAVITY
Normal appearance Squamous epethelium Ciliated epethelium Transition Duct orifices Microvascular network
04
/07
/20
23
19
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF THE NASAL CAVITY
Abnormal appearance Chronic rhinitis Allergic rhinitis Nasal polyps
Contact endoscopy and FESS Assess state of mucosa
04
/07
/20
23
20
Dept o
f EN
T, A
FMC
, Pune
04
/07
/20
23
21
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF THE NASAL CAVITY
04
/07
/20
23
22
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF NASOPHARYNX
Normal appearance Ciliated epethelium Squamous epethelium in central and inferior part
of posterior wall Abnormal appearance
Irregular vascular pattern Anysokaryosis, heterochromasia Hyperchromatic nuclei
04
/07
/20
23
23
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF NASOPHARYNX
Abnormal appearance Diagnosis and follow up of nasophyrngeal
carcinoma Endemic areas Select areas for biopsy
04
/07
/20
23
24
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF ORAL CAVITY AND OROPHARYNX
Normal appearance Morphology varies from site to site Masticatory mucosa
04
/07
/20
23
25
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF ORAL CAVITY AND OROPHARYNX
Abnormal appearance Early cancer Tumour margins Assessment of radiotherapy and chemotherapy Identify subclinical stages
04
/07
/20
23
26
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF ORAL CAVITY AND OROPHARYNX
04
/07
/20
23
27
Dept o
f EN
T, A
FMC
, Pune
CONTACT ENDOSCOPY OF ORAL CAVITY AND OROPHARYNX
04
/07
/20
23
28
Dept o
f EN
T, A
FMC
, Pune
RECENT ADVANCES
Identification of parathyroid glands during thyroid surgery
04
/07
/20
23
29
Dept o
f EN
T, A
FMC
, Pune
RECENT ADVANCES
Contact Endoscopy Vs Frozen section
04
/07
/20
23
30
Dept o
f EN
T, A
FMC
, Pune
SUMMARY
Allows in vivo and in situ assessment Improves accuracy of diagnosis Identify early subclinical disease Improvements in optical systems In future it will occupy central role in
diagnosis, therapeutic planning and follow up
04
/07
/20
23
31
Dept o
f EN
T, A
FMC
, Pune
REFERENCES Scott-Brown’s Otorhinolaryngology, Head and Neck
Surgery, 7th Edition Journal of Oncology ,Volume 2011, Article ID 196302,
Contact Endoscopy as a Novel Technique in the Detection and Diagnosis of Mucosal Lesions in the Head and Neck: A Brief Review
ACTA otorhinolaryngologica italica 2007;27:59-61, Contact endoscopy of the oral mucosa: preliminary results
ACTA otorhinolaryngologica italica 2010;30:20-26, Contact endoscopy for identifying the parathyroid glands during thyroidectomy
Auris Nasus Larynx 34 (2007) 45–48, Contact endoscopy of the nose in patients with Rendu–Osler–Weber syndrome
04
/07
/20
23
32
Dept o
f EN
T, A
FMC
, Pune
Thank you
