Effectiveness of indirect autofluorescent laryngoscopy in the diagnosis of cancerous and precancerous lesions of the larynx

Autofluorescent diagnostics are based on the ability of oxidized flavin mononucleotide [FMN] in normal cells to emit green fluorescence when exposed to blue light. Neoplastic cells have significantly lower concentrations of FMN and do not emit green fluorescence. Autofluorescent endoscopy is designed for early, accurate and minimally invasive diagnostics for laryngeal pathology. The aim of the present study was to evaluate the diagnostic potential and limitations of this imaging technique in comparison to laryngomicroscopy. In our investigation we used the System of Autofluorescent Endoscopy [SAFE 1000] designed by Pentax. We examined 32 patients using the SAFE 1000 system, and then all of the patients underwent indirect laryngomicroscopy [LMS]. In LMS, a biopsy was taken, and the diagnostic sensitivity of these two methods was compared according to the pathohistological diagnosis. For statistical evaluation we used Fisher's exact test. Comparable to indirect autofluorescence images, normal laryngeal mucosa showed a typical green fluorescence signal. Moderate and high epithelial dysplasia, carcinoma in situ and cancer displayed a diminished green fluorescence. False negative results were related to extreme hyperkeratosis. According to our results, the presented technique seems to be a promising diagnostic tool for the early detection of laryngeal cancer and its precursor lesions. It has the ability to give information about the nature of laryngeal lesions without devastation of the tissues. We believe that autofluorescent endoscopy in addition to laryngomicroscopy gives a more accurate diagnosis of laryngeal pathology than laryngomicroscopy alone

Powered endoscopic inferior turbinoplasty versus conventional partial inferior turbinectomy for hypertrophic inferior turbinate

Chronic nasal obstruction due to hypertrophic inferior turbinates is a common disorder. A variety of surgical procedures are performed for treatment of hypertrophic inferior turbinates. We evaluated objectively [by postoperative endoseopy] and subjectively [by questionnaire] 60 patients who underwent one of two procedures; Conventional partial inferior turbinectomy [Conventional PIT] and Powered Endoscopic partial inferior turbinoplasty [Powered Endoscopic PIT]. The CPIT and PEPIT showed good functional results for long term effectiveness [80% and 86.7% respectively]. Long term follow up revealed high level of satisfaction of both techniques. Less morbidity [less bleeding, synaechae, crusts and fewer days of hospital stay] was recorded with PEPIT. Thus powered endoscopic inferior partial turbinoplasty offers an excellent method of correction of turbinate hypertrophy with minimal intraoperative and postoperative complications and significant long term improvement

Management of osteomas of the nose and paranasal sinuses

Craniofacial osteomas are benign tumors of the skull base, often involving the nose and paranasal sinuses. The aim of the present study is to compare different approaches in the management of osteomas of the nose and paranasal sinuses. In this study 20 patients were treated for osteomas within the nose and paranasal sinuses. All patients had standard radiological studies and computed tomography with coronal and axial cuts of the nose and paranasal sinus. Four cases were Asymptomatic and so managed conservatively. Surgery was done for 16 symptomatic cases. We used endoscopic approach in 8 out of 16 symptomatic patients. Endoscopic and radiological follow-up ranging from 6m to 24 months was done postoperatively. In our study we found that nasoendoscopic approach allows closer and more direct visualization during surgical removal of osteoma and with the aid of the intranasal drill for osteoma fragmentation and root separation, hemorrhage was more easily controlled, and extensive excision was minimized, with no cosmotic complications occurred