Abstract
Diagnosis and treatment of vocal fold lesions has been a long-evolving science for the otolaryngologist. Contemporary practice requires biopsy of a glottal lesion in the operating room under general anesthesia for diagnosis. Current in-office technology is limited to visualizing the surface of the vocal folds with fiber-optic or rigid endoscopy and using stroboscopic or high-speed video to infer information about submucosal processes. Previous efforts using optical coherence tomography (OCT) have been limited by small working distances and imaging ranges. Here we report the first full field, high-speed, and long-range OCT images of awake patients’ vocal folds as well as cross-sectional video and Doppler analysis of their vocal fold motions during phonation. These vertical-cavity surface-emitting laser source (VCSEL) OCT images offer depth resolved, high-resolution, high-speed, and panoramic images of both the true and false vocal folds. This technology has the potential to revolutionize in-office imaging of the larynx.
Highlights
Several basic studies and clinical investigations have focused on examining human vocal fold structure, they have necessarily been performed primarily under general anesthesia[2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]
The basement membrane (BM) is not resolved with OCT as it is a fibrous layer two cells thick
In the superficial lamina propria (SLP), there is an increase in optical scattering that may be due to the increased collagen density in the SLP layer as well as the presence of a microvasculature
Summary
Applications and technology development for laryngeal OCT imaging has been fairly limited because it typically must be accomplished in contact or near-contact mode, and in general this requires sedation and surgical endoscopy. Moving this technology from the operating room to the office has been an objective for several research groups for well over a decade[10,17,18,19,20,21,22,23]. We report the first full frame, in vivo, cross-sectional imaging of the vocal folds during phonation using an OCT system incorporating a vertical-cavity surface-emitting laser source (VCSEL). We demonstrated in healthy normal volunteers: 1) the real-time, cross sectional structure of both the true and false vocal folds, 2) the native vibration of the vocal folds, and 3) the Doppler shift induced by the vocal fold vibration in vivo
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