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Use of Smartphone, NBI for Examination Reviewed in Studies

Twelve presentations were made during Scientific Oral Presentations, “Laryngology/Broncho-Esophagology” Tuesday morning.

Use of a New Coupling Device to Record Fiberoptic Laryngoscopies on to a Smartphone

The use of a smartphone to record a flexible fiberoptic laryngoscopy was tested by the University of Pennsylvania Health System Department of Otorhinolaryngology-Head and Neck Surgery.

In the study, an adapter was used to attach a smartphone to an endocscope and align the camera with the eyepiece. Approximately 30 seconds of video was recorded, and the video was transmitted electronically and reviewed by a second laryngologist blinded to the findings of the live exam. These recordings were judged “of sufficient quality, and diagnoses made based on them correlate well with the current standard of live examination.”

Value of NBI in Early Detection of  Laryngeal Neoplasms

The Department of Otolaryngology-Head & Neck Surgery at the Second Hospital of Jilin University, Jilin, China, evaluated the value of narrow band imaging (NBI) endoscopy in examining the characteristics of laryngeal carcinoma. The study used conventional white light (CWL) and NBI on three groups of patients: a malignant group, a precancerous group, and a benign group.

Researchers were able to switch between CWL and NBI using a fingertip switch, and found that NBI enhances the sensitivity and accuracy of laryngeal lesions.

Three Studies from Kaplan Medical Center, Israel

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Hagit Shoffel-Havakuk, MD, makes one of her three presentations Tuesday during Scientific Oral Presentations: Laryngology/Broncho-Esophagology.

The Department of Otolaryngology Head and Neck Surgery at Kaplan Medical Center, Rehovot, Israel, had three presentations.

“The Anatomic Location and Distribution Pattern of Malignant and Pre-Malignant Glottic Lesions” studied the anatomic location and distribution pattern of glottic dysplasia and squamous cell carcinoma to better understand the anatomic locations where glottic carcinogenesis  initiates. The study found that malignant and pre-malignant lesions tend to involve the medial aspect more than the superior aspect on presentation, and the most involved area is the midpoint of the membranous part at the transition between the superior and medial aspects.

“Transnasal Office-Based Laryngeal Surgery Using a Distal Chip Endoscope With a Working Channel” assessed the advantages, limitations, and risks treatment options in the office. Researchers concluded that the distal chip endoscope improves the ability to perform office procedures, is well tolerated by most adults, and is a safe and cost-effective alternative to general anesthesia.

“Narrow Band Imaging (NBI): Demonstration of Laryngeal Microvascularization in Normal and Pathological Conditions” was similar to the NBI study at Second Hospital of Jilin University and had a similar finding that NBI helps to identify vascular pattern and contrasted keratin.

Long Term Survival Of Autologous Fat Grafts Into the Vocal Folds

The Instituto De Laringologí­a Fundación Santa Fe De Bogota at University Hospital Bogotá, Colombia, studied whether it is possible for fat to survive long-term after injection into the vocal folds.

The study concluded that MRI demonstrates that fat is present in both vocal folds. Autologous fat obtained by means of dissection is a good injectable material, and long-term follow-up with MRI demonstrates that the tissue survives into the vocal folds, acting as a permanent implant. The technique yields good permanent results in properly selected cases.

Spasmodic Dysphonia: A 20-Year Experience of Injecting Botulinum Toxin

A study from St. Louis University School of Medicine examined botulinum toxin injections to see if they were unilateral and what dosing patterns were used.

Researchers found that those receiving unilateral injections often had side effects and a consistent dosage was not used, but patients chose to continue treatment. Trends in doses were inconsistent for the first eight treatments, but a trend developed by the 15th injection.

Trends in Utilization of Vocal Fold Injection Procedures

This study from the Department of Otolaryngology at the University of Miami Miller School of Medicine examined claims in the U.S. Medicare Part B database for vocal fold injections in the office and the operating room.

The results showed that office injections had not increased, but operating room injections had. The presenter, David E. Rosow, MD, discussed confusion over the codes used in claims and concluded that coding clarification is needed.

Evaluation of Airway and Voice Following Posterior Transverse Cordotomy for Bilateral Vocal Fold Paralysis

The degree of airway improvement after unilateral posterior transverse cordotomy for bilateral vocal fold paralysis was examined using pulmonary function test data by researchers at the Oregon Health Sciences University and the University of Southern California.

The data also included inspiratory flow loops and was used to determine the impact of cordotomy on voice-related quality of life.

Researchers found that posterior transverse cordotomy alone improves peak inspiratory flow rate by approximately 90 percent, that inspiratory flow loops can be used to evaluate surgical outcomes and follow-up, and that posterior transverse cordotomy does not result in a significant change in voice-related quality of life.

Other presentations were:

  • Functional Electrical Stimulation of the Larynx With a Flexible Ribbon Electrode Array
  • Clinical Study of Postoperative Swallowing in Multiple-System Atrophy
  • Detection and Characterization of Laryngeal Reflex Pathology in Mouse Models of Human Diseases