Assessing the Learning Curve in Contact Endoscopy for Oral and Oropharyngeal Examination

Abstract

The early and accurate detection of oral and oropharyngeal malignant lesions is crucial, impacting both treatment outcomes and patient prognosis. Contact endoscopy is one of the prospective methods in this respect. However, the integration of contact endoscopy into routine clinical practice is not without challenges. It requires specific skills and expertise for both performing the procedure and interpreting the enhanced mucosal images (the type of vascular patterns). We conducted a prospective analysis over a 9-month period, involving otolaryngologists (n=18) at various stages of their careers. To assess the learning curve, we evaluated both the technical proficiency and diagnostic accuracy of participants at multiple time points: at baseline, 1 month after initial training, and at 3, 6, and 9 months. At baseline, the average time to complete a contact endoscopy procedure was 180.7 seconds for the more experienced investigator and 185.7 seconds for the less experienced investigator, reducing to 120.2 seconds and 123.2 seconds at the 9-month assessment, respectively. Image clarity also improved, with only 34.5% of initial images deemed 'high quality', increasing to 94,5% after 9 months for more experienced investigator. The correct interpretation of the contact endoscopy findings did not depend much on the number of high-quality images.