Optical coherence tomography monitoring for laser surgery of laryngeal carcinoma

Background and Objective: The goal of this study is to apply a new bioimagi ng modality, the Optical Coherence Tomography (OCT), for intraoperative con trol in laser surgery of laryngeal carcinoma. Study Design/Materials and Methods: We studied 26 patients with laryngeal c arcinoma in situ and in T-1, T-2 stage. We used an endoscopic OCT device fo r imaging at a wavelength of 0.83 mum with the acquisition rate of approxim ately 0.5 frames/s for a single (200 x 200 pixel) tomogram. All patients we re operated with a surgical YAG:Nd laser at two switchable wavelengths of 1 .44 mum and 1.32 mum by laryngofissure, direct microlaryngoscopy, and fibro laryngoscopy. Results: Information on structural alterations in laryngeal mucosa to the z depth of 2 mm, obtained by OCT, makes it possible to precisely locate tumo r borders, thus giving an opportunity to control the surgical treatment of laryngeal carcinoma. The YAG:Nd laser scalpel with wavelengths of 1.32 tm a nd 1.44 tm is successful in surgical procedures both in open and closed lar ynx due to efficient coagulation and minimization of collateral tissue dama ge area. Combination of the two wavelengths in the single laser unit and in traoperative OCT monitoring result is a new modality for minimally invasive larynx surgery. Conclusions: OCT is promising to become a new diagnosing method of laryngea l carcinoma and a tool for laser treatment monitoring. J. Surg. Oncol. 2001 ;77:253-258. (C) 2001 Wiley-Liss, Inc.