Optical coherence tomography in the laryngeal arytenoid mucosa for documentation of pharmacological treatments and genetic aspects: a protocol

Abstract

BackgroundOptical coherence tomography (OCT) is an imaging technology that provides cross-sectional images of subsurface tissue structures in the larynx without biopsy. Focus has until now been on the vocal folds. Since many kinds of mucosal disorders can be defined in the arytenoid regions behind the vocal folds, and not on the vocal folds, we focus on this area in this protocol.ObjectiveA superficial oedema, grading 1–5 of the arytenoid regions, can be made with high-speed films of 4,000 pictures/sec. A supplementary larynx set up with a clinical probe for OCT with cross-sectional measures can be made with a description of the levels of oedema and other parameters.DesignAdult patients with subjective complaints of hoarseness or a problem in the larynx related to voice and swallowing for more than 6 weeks participated in a randomised-controlled study.Perspective and conclusionWith this new OCT probe for the larynx arytenoid region, compared with high-speed films, we will be able to define pathological areas in the arytenoid mucosa as a future documentation of pharmacological treatment and genetics-related lifestyle advice.In ContextOptical coherence Tomography is a very promising way of looking down into tissue with no need of a biopsy. It has been used extensively in eye and skin disorders. For the least 10 years the focus has also been on the throat, especially in cancer patients and on the vocal folds. Due to our experience with high speed films of the vocal folds (4000 pictures per second) has shown not only the vocal fold, but the region behind the vocal folds. An area where voice, respiration and swallowing meets. This protocol intends to propagate development of a probe to look at the tissue in the throat, including behind the vocal folds. Especially pharmacological treatment effects and genetic differences are of interest. Development of the probe for clinical use seems to be difficult, but it is possible together with engineers who already developed probes for other areas of the human body.