Clinical and surgical implications of intraoperative optical coherence tomography imaging for benign pediatric vocal fold lesions

Benboujja, Fouzi; Hartnick, Christopher J.

doi:10.1016/j.ijporl.2018.08.036

Cited by 9 publications

(6 citation statements)

References 38 publications

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“…To reduce bias in the selection of the region of analysis across volumes, we extracted features along the 45° midline from the VF edge epithelium. The 45° landmark is easily identifiable and trackable during endoscopy 34 . It allows to symmetrically cross the vocal fold edge and all layers of the lamina propria.…”

Section: Methodsmentioning

confidence: 99%

“…under near-infrared wavelengths (ranging from 800 to 1300 nm), enables depth-resolved images up to 2.5 mm with a high axial resolution (1 to 12 μm) [20][21][22][23] . Its clinical potential has been well-demonstrated in laryngeal studies, such as in subglottic stenosis in adults [24][25][26] , and neonates 27 , vibrating VFs [28][29][30] , VF injections 31 and with benign and malignant lesions 24,28,30,[32][33][34][35][36] . Furthermore, OCT provides means to characterize and quantify the mucosa motion with doppler analysis [28][29][30] , describe subglottic injuries with a second-order statistics 37 , and its composition with attenuation coefficients 38,39 .…”

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confidence: 99%

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Quantitative evaluation of the human vocal fold extracellular matrix using multiphoton microscopy and optical coherence tomography

Benboujja

Hartnick

2021

Sci Rep

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Identifying distinct normal extracellular matrix (ECM) features from pathology is of the upmost clinical importance for laryngeal diagnostics and therapy. Despite remarkable histological contributions, our understanding of the vocal fold (VF) physiology remains murky. The emerging field of non-invasive 3D optical imaging may be well-suited to unravel the complexity of the VF microanatomy. This study focused on characterizing the entire VF ECM in length and depth with optical imaging. A quantitative morphometric evaluation of the human vocal fold lamina propria using two-photon excitation fluorescence (TPEF), second harmonic generation (SHG), and optical coherence tomography (OCT) was investigated. Fibrillar morphological features, such as fiber diameter, orientation, anisotropy, waviness and second-order statistics features were evaluated and compared according to their spatial distribution. The evidence acquired in this study suggests that the VF ECM is not a strict discrete three-layer structure as traditionally described but instead a continuous assembly of different fibrillar arrangement anchored by predominant collagen transitions zones. We demonstrated that the ECM composition is distinct and markedly thinned in the anterior one-third of itself, which may play a role in the development of some laryngeal diseases. We further examined and extracted the relationship between OCT and multiphoton imaging, promoting correspondences that could lead to accurate 3D mapping of the VF architecture in real-time during phonosurgeries. As miniaturization of optical probes is consistently improving, a clinical translation of OCT imaging and multiphoton imaging, with valuable qualitative and quantitative features, may have significant implications for treating voice disorders.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Quantitative evaluation of the human vocal fold extracellular matrix using multiphoton microscopy and optical coherence tomography

Benboujja

Hartnick

2021

Sci Rep

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“…He mentioned in the paper that precise delineation of VF-layered microstructure provides useful information for precise detection of the VF lesions along the unique layered structure [27]. Recent studies [28,29,30] presented the usefulness of this technique especially during surgical intervention to the various types of the VF lesions including VF scars. Heris et al recently characterized the VFs microstructure and elasticity using nonlinear laser scanning microscopy and atomic force microscopy-based indentation, respectively [31].…”

Section: The Unique Microstructure Of the Vf And Imaging The Strucmentioning

confidence: 99%

Pathophysiology of Fibrosis in the Vocal Fold: Current Research, Future Treatment Strategies, and Obstacles to Restoring Vocal Fold Pliability

Kumai

2019

IJMS

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Communication by voice depends on symmetrical vibrations within the vocal folds (VFs) and is indispensable for various occupations. VF scarring is one of the main reasons for permanent dysphonia and results from injury to the unique layered structure of the VFs. The increased collagen and decreased hyaluronic acid within VF scars lead to a loss of pliability of the VFs and significantly decreases their capacity to vibrate. As there is currently no definitive treatment for VF scarring, regenerative medicine and tissue engineering have become increasingly important research areas within otolaryngology. Several recent reviews have described the problem of VF scarring and various possible solutions, including tissue engineered cells and tissues, biomaterial implants, stem cells, growth factors, anti-inflammatory cytokines antifibrotic agents. Despite considerable research progress, these technical advances have not been established as routine clinical procedures. This review focuses on emerging techniques for restoring VF pliability using various approaches. We discuss our studies on interactions among adipose-derived stem/stromal cells, antifibrotic agents, and VF fibroblasts using an in vitro model. We also identify some obstacles to advances in research.

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“…Through an interferometric scheme, OCT provides cross‐sectional images of biological tissue with a sufficient resolution (~10 μm) to compile meaningful and trackable VF anatomical features. Its clinical potential has been previously demonstrated for detecting laryngeal benign and malignant lesions 30–37 measuring subglottic stenosis in adults, 36,38,39 and neonates, 40 and guiding VF injections 41 …”

Section: Introductionmentioning

confidence: 99%

“…Through an interferometric scheme, OCT provides cross-sectional images of biological tissue with a sufficient resolution ($10 μm) to compile meaningful and trackable VF anatomical features. Its clinical potential has been previously demonstrated for detecting laryngeal benign and malignant lesions [30][31][32][33][34][35][36][37] measuring subglottic stenosis in adults, 36,38,39 and neonates, 40 and guiding VF injections. 41 Considering that it is challenging to evaluate the pediatric voice and how the microanatomy evolves, this study aims to visualize and characterize how the VF subepithelial structures are modulated during growth.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Human Vocal Fold Lamina Propria Development Using Optical Coherence Tomography

et al. 2021

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Objectives/Hypothesis Identifying distinctive features of the vocal fold (VF) during development could have significant clinical implications for treating voice disorders. This study investigates the structural organization of the VF microanatomy across gender and age groups using optical coherence tomography (OCT). Study Design Prospective clinical trial. Materials and Methods In vivo OCT images were acquired from 97 patients (58 males and 39 females) aged between 6 weeks and 27 years. All patients showed no signs of vocal fold pathology on endoscopy. Morphological features were extracted from OCT images and statistically compared between age groups. This study was performed at Massachusetts Eye and Ear between 2017 and 2019. Results All OCT acquisitions show a stratified microanatomy across age groups, even in newborns suggesting the presence of a superficial lamina propria (SLP) at birth. Furthermore, the optical scattering in the VF lamina propria changes according to age, suggesting subepithelial maturation. Although the epithelium thickness was relatively constant across age groups, the SLP showed a significant linear relationship between age and thickness (P = .016). Furthermore, a significant difference (P = .002) in SLP thickness was found between young adult males and females. The overall thickness of the entire mucosa did not change significantly with age. Conclusion OCT is a noninvasive imaging modality capable of providing quantitative morphological features to describe the VF development. A stratified structure can be observed in OCT from newborns to young adults. Further investigations could combine OCT, acoustic measurements, and molecular sensitive techniques to provide a complete interpretation of the VF development. Level of Evidence NA Laryngoscope, 131:E2558–E2565, 2021

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Clinical and surgical implications of intraoperative optical coherence tomography imaging for benign pediatric vocal fold lesions

Cited by 9 publications

References 38 publications

Quantitative evaluation of the human vocal fold extracellular matrix using multiphoton microscopy and optical coherence tomography

Quantitative evaluation of the human vocal fold extracellular matrix using multiphoton microscopy and optical coherence tomography

Pathophysiology of Fibrosis in the Vocal Fold: Current Research, Future Treatment Strategies, and Obstacles to Restoring Vocal Fold Pliability

Evaluation of the Human Vocal Fold Lamina Propria Development Using Optical Coherence Tomography

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