Xin Lv, Jing‐Jing Lu, Si‐Meng Song, Yi‐Ru Hou, Yan‐Jun Hu, Yan Yan, Tao Yu, Dong‐Man Ye
Publication date 15-04-2024
Abstract Introduction To evaluate the diagnostic efficiency among the clinical model, the radiomics model and the nomogram that combined radiomics features, frozen section (FS) analysis and clinical characteristics for the prediction of lymph node (LN) metastasis in patients with papillary thyroid cancer (PTC).
MethodsA total of 208 patients were randomly divided into two groups randomly with a proportion of 7:3 for the training groups (n = 146) and the validation groups (n = 62). The Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for the selection of radiomics features extracted from ultrasound (US) images. Univariate and multivariate logistic analyses were used to select predictors associated with the status of LN. The clinical model, radiomics model and nomogram were subsequently established by logistic regression machine learning. The area under the curve (AUC), sensitivity and specificity were used to evaluate the diagnostic performance of the different models. The Delong test was used to compare the AUC of the three models.
Results Multivariate analysis indicated that age, size group, Adler grade, ACR score and the psammoma body group were independent predictors of lymph node metastasis (LNM). The results showed that in both the training and validation groups, the nomogram showed better performance than the clinical model, albeit not statistically significant (p > .05), and significantly outperformed the radiomics model (p < .05). However, the nomogram exhibits a slight improvement in sensitivity that could reduce the incidence of false negatives.
Conclusion We propose that the nomogram holds substantial promise as an effective tool for predicting LNM in patients with PTC.
Marc C. den Heijer, Gonneke E. Joustra, Karin M. Vermeulen, Astrid G. W. Korsten‐Meijer, Robert A. Feijen
Publication date 13-04-2024
Abstract Objectives Existing knowledge on health-related quality of life (HRQoL) after surgical removal of sinonasal inverted papilloma (IP) is limited. Moreover, predictors for a better or worse post-operative HRQoL outcome are not known. Our aim was to assess HRQoL in all three health domains (physical, psychological, and social), track its post-operative trajectory, investigate if pre-operative observations could predict distinct post-operative HRQoL outcomes, and evaluate whether physicians interventions could contribute to improved post-operative HRQoL.
Design Prospective cohort study.
Setting Tertiary referral hospital.
Participants Seventy-four patients who underwent surgery for an IP were included. They were asked to fill in the Endonasal Endoscopic Sinus and Skull-Base Surgery Questionnaire (EES-Q) pre-operatively, and then 2 weeks, 3 months, and 1 year post-operatively.
Main Outcome Measures Linear mixed models analyses were performed to evaluate the overall post-operative HRQoL and the separate health domains, as well as the impact of specific variables (sex, age, American Society of Anaesthesiologists ASA classification, smoker, Krouse staging, pre-operative EES-Q score, type of surgery, and post-operative antibiotics) on HRQoL improvement.
Results The total EES-Q score (p < .001) as well as the physical (p < .001), psychological (p = .049), and the social (p = .002) domains significantly improved post-operatively. ASA classification (p = .049), pre-operative EES-Q score (p < .001) and post-operative antibiotics (p = .036) were significant variables.
Conclusions Overall HRQoL, as well as each of the three health domains, improved significantly. A higher ASA score, a higher pre-operative EES-Q score, and the administration of post-operative antibiotics were significant predictors for better HRQoL recovery post-operatively. Further research is necessary to confirm these results.
Publication date 12-04-2024
Ruggero Campisi, Alberto Caranti, Giuseppe Meccariello, Luigi Marco Stringa, Chiara Bianchini, Andrea Ciorba, Stefano Pelucchi, Claudio Vicini
Publication date 12-04-2024
Abstract Objectives The aim of the study is to conduct a systematic review of the existing literature on styloidectomy performed through transoral robotic surgery (TORS) in Eagle syndrome (ES).
Design and Setting Two independent reviewers (RC and AC) conducted a systematic review of Pub Med and Embase databases, seeking articles on TORS performed for ES treatment. The search was conducted in July 2023. The review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Participants The review included a total of 17 adult patients, comprising 12 females and 5 males, with an average age of 52.2 years, all diagnosed with ES.
Main Outcome Measures For each patient, we assessed the overall length of the styloid process, the affected side, total intervention duration, hospitalization duration, pre and postoperative Visual Analogue Scale (VAS) scores, and the presence of minor and major complications.
Results We identified 4 articles describing 17 instances of TORS as a surgical treatment for ES in the literature, totaling 18 styloidectomies. The mean age of the patients was 52.2 years, with 12 females and 5 males. The average operation time, inclusive of the docking phase, was 68.8 minutes. Sixteen patients (94.1% of the total) experienced complete symptom disappearance or near-complete resolution after surgery. One patient (5.9%) showed improvement categorized as non-meaningful. Only one case of minor complication was reported among the 17 procedures (5.9%).
Hendrik Falz, Hans‐Jürgen von Lücken, Adrian Münscher, Nikolaus Möckelmann
Publication date 12-04-2024
Abstract Objectives To analyse operating time, intraoperative blood loss, postoperative bleeding rate and pain when using the relatively new Bi Zact™ tonsillectomy device compared to the commonly used cold steel dissection technique with bipolar cautery in adults.
Design Retrospective case control study. Parameters analysed for significant association with technique were operating time, intraoperative blood loss, wound pain on postoperative days 1–4 and rate of post-tonsillectomy bleeding (PTB).
Setting Monocentric study at a department of otolaryngology and head and neck surgery at a tertiary centre in Germany.
ParticipantsA total of 183 patients who underwent a bilateral tonsillectomy with either the Bi Zact™ tonsillectomy device or the cold dissection technique with bipolar cautery for haemostasis.
Main Outcome Measures Operating time, intraoperative blood loss, postoperative pain on the first to fourth postoperative day (numeric rating scale: 0–10) (PTB, primary bleeding ≤24 h, secondary bleeding >24 h postoperative; Stammberger scale).
Results and Conclusion The Bi Zact™ tonsillectomy device leads to a significant shorter operating time with less intraoperative blood loss compared to cold steel dissection with bipolar haemostasis. No benefits with regards to PTB or postoperative pain could be observed. The use of the Bi Zact™ device provides major benefits in clinical routine and stands up to conventional tonsillectomy techniques.
M. E. Walsh, R. Retzler, J. Huang, A. Daglish, D. Tweedie, C. Pepper
Publication date 12-04-2024
Abstract Objectives Paediatric feeding difficulties are common, affecting up to 25% of otherwise healthy children, symptoms include food refusal, gagging, choking, and excessive mealtime duration. These symptoms are commonly described in pre-operative discussions about tonsillectomy. This prospective study explores the impact of tonsillectomy on paediatric feeding difficulties.
Design This prospective cohort study invited caregivers of children undergoing tonsillectomy to complete a PediEAT questionnaire about their childrens feeding behaviours, pre and post-operatively. The study was completed in two phases with 9 questions administered in phase 1 and three additional questions added for phase 2. A free text comments box was also provided. Responses were graded from 0 to 5, where 0 is ‘never a problem’ and 5 is ‘always a problem’ with eating behaviours.
Setting The study was conducted at our institution, a tertiary paediatric ENT unit.
Participants Children aged between 6 months - 7 years undergoing tonsillectomy for any indication were invited to participate.
Main outcome measures Changes to the Pedi-EAT scores pre and post operatively were the main outcome measure.
Results102 participants were recruited between January 2020 and January 2022. The mean age of participants was 4.1 years, 87% had a concurrent adenoidectomy. The mean time to completion of post-operative questionnaire was 23 weeks after surgery. 9 of the 12 questions showed a statistically significant improvement in post-operative scores using a paired student t-test (p < 0.05). The most significant improvements related to ‘gets tired from eating and is not able to finish’ (1.49 pre-op, 0.91 post op, p < 0.01) and ‘eats food that needs to be chewed’ (1.4 pre-op, 0.72 post-op, p < 0.01). 13% of participants only underwent tonsillectomy and this group also showed a statistically significant improvement in fatigue during eating (p < 0.05).
Conclusion Symptoms of fatigue during eating and avoidance of food requiring mastication are most likely to improve following tonsillectomy in children.
Kyung Soo Kim, Il‐Youp Kwak, Hyun Jin Min
Publication date 12-04-2024
Abstract Objective To investigate the clinical characteristics associated with measured gustatory dysfunction in patients with chemosensory (smell and taste) discomfort.
Study design Retrospective study.
Design Hospital-based cohort.
Setting The clinical characteristics associated with the measured diagnosis of gustatory dysfunction were statistically analysed.
Participants Patients who underwent all the psychophysical olfactory and chemical gustatory function tests (YSK olfactory function test and chemical gustometry exam) and the subjective questionnaires between October 2021 and February 2023.
Main outcome measuresYSK olfactory function test and chemical gustometry results, subjective questionnaire score about chemosensory (smell and taste) functions. The Medical records of patients who visited the smell and taste centre in a tertiary.
ResultsA total of 219 patients were enrolled; 180 were diagnosed as having normal gustatory function, and 39 were diagnosed as having gustatory dysfunction. Subjective recognition of gustatory function was not associated with the measured gustatory function. Age, sex, measured olfactory function and the threshold and discrimination scores for the olfactory function test were significant factors in the multivariate analysis. When the patients were further divided according to age, the threshold test scores rather than other subsets in the olfactory function test were significantly associated with measured gustatory dysfunction in patients 60 and older.
Conclusion In older adult male patients with olfactory dysfunction, gustatory function should be considered regardless of subjective gustatory dysfunction.
Davide Rizzo, Roberto Gallus, Pierangela Tramaloni, Luca Mureddu, Paolo Tropiano, Claudia Crescio, Emilia Degni, Alberto Artuso, Francesco Bussu
Publication date 12-04-2024
Lena Hafrén, Laura K. Mäkinen, Aaro Haapaniemi, Johanna Jokela, Riitta Saarinen
Publication date 12-04-2024
Tejas Subramanian, Helena Levyn, Alana Eagan, Nora Katabi, Daniel Scholfield, Jatin P. Shah, Richard J. Wong, Ian Ganly, Snehal G. Patel
Publication date 12-04-2024
Thushanth Sooriyamoorthy, Eniola Salau, Mohammad Ghunaim, Ananth Vijendren
Publication date 12-04-2024
Benjamin James Talks, Nola Lynch, Isobel Bowe, Charles Kelly, Muhammad Shahid Iqbal
Publication date 12-04-2024
Ahmed Nofal, Mohammad Waheed El‐Anwar
Publication date 12-04-2024
Abstract Objective To assess the endoscopic assisted excision of the nasoorbital dermaoid cyst.
Desigh Case series.
Setting Zagazig univesity hospitals.
Particpant The study included patients with nasal dermoid who were operated using a local vertical incision with endoscopic assisted dissection and excision.
Main outcome measures Complete removal, complication, recurrence.
Results In all patients, complete excision of the cyst was achieved with negligable blood loss. No recurrence was detected throughout the follow up.
Conclusion Endoscopic-assisted resection of the nasal dermoid cyst appears a safe and effective approach with small incision, precise dissection and satisfactory apparent scar with with low incidence of recurrence.
Gemma M. Clunie, Justin W. G. Roe, Chadwan Al‐Yaghchi, Caroline M. Alexander, Alison McGregor, Gurpreet Sandhu
Publication date 12-04-2024
Abstract Objectives Airway reconstruction for laryngo tracheal stenosis (LTS) improves dyspnoea. There is little evidence relating to impact upon voice and swallowing. We explored voice and swallowing outcomes in adults with LTS before and after reconstructive surgery.
Design Outcome measures were collected pre-reconstructive surgery, two-weeks post-surgery and up to 4-6 months post-surgery.
Setting Tertiary referral centre.
Participants With ethical approval, twenty consecutive adult (≥18 years) LTS patients undergoing airway reconstruction were prospectively recruited.
Main outcome measures These included physiological values (maximum phonation time (MPT) and fundamental frequency; penetration aspiration score, residue score), clinician-reported (GRBAS, functional oral intake score, 100ml Water Swallow Test) and patient-reported outcomes (Voice Handicap Index-10, Reflux Symptoms Index, Eating Assessment Tool, Dysphagia Handicap Index).
Results The observational study identified patient-reported and clinician-reported voice and swallow difficulties pre- and post-surgery; median and interquartile range are reported at each time point: Voice Handicap Index-10 23 (8-31); 20.5 (9-33.5), 24.5 (12.5-29); Dysphagia Handicap Index 9 (0-37); 13 (7-44); 15 (4-34); GRBAS grade 1(1-2); 2 (1-2.5); 2(1-2); 100ml Water Swallow Test volume score 16.7 (11.1-20); 14.3 (12.5-16.7); 16.7 (14.3-20.0); 100ml Water Swallow Test capacity score 16.3 ± 9.0; 11.0 ± 4.1; 12.5 ± 2.6.
Conclusions We present the first prospective data on voice and swallowing outcomes in adults with LTS before and after reconstructive surgery. The variability of the outcomes was higher than expected but importantly, for many the voice and swallow outcomes were not within normal limits before surgery. The clinical value of the study demonstrates the need for individual assessment and management of LTS patients’ voice and swallowing.
Benyamin M. Kaminer, Sabri El‐Saied, Batel Lasry, Daniel M. Kaplan
Publication date 12-04-2024
Abstract Introduction Necrotizing otitis externa (NOE) is a serious, progressive, and potentially life-threatening infection of the external auditory canal, affecting soft tissue and bone. The most common organism causing NOE is Pseudomonas Aeruginosa and less common are Fungal infections. When managing a patient with NOE, a culture is taken from the EAC in order to tailor the appropriate antimicrobial treatment, however commonly, the culture is sterile. Inflammation biomarkers may be used as adjuncts to inform on the differential diagnosis and as prognostic markers.
Aim To characterize and compare values and ratios of components of the complete blood count (CBC) at admission, at patients with positive swab culture.
MethodsA retrospective study of NOE patients was conducted. We included all patients admitted between the years 2001-2023, for whom a culture swab tested positive. We compared CBC findings at hospitalization between bacteria and fungi-positive culture patients.
Results Eosinophils-to-Neutrophils Ratio (ENR) was significantly lower in the fungal group compared to the bacterial group 0.023 ± 0.02 and 0.04 ± 0.03, respectively (p-value = 0.025). Eosinophils-to-Leukocyte Ratio (ELR) was significantly lower in the fungal group compared to the bacterial group 0.058 ± 0.04 and 0.12 ± 0.1 respectively (p-value = 0.009). For definition of ELR ≤ 0.1 we found that, sensitivity was 88% (95%CI = 0.679-0.979) and NPV 90% (95%CI = 0.709-0.982). For definition of ENR ≤ 0.03 sensitivity was 88% (95%CI = 0.679-0.979) and NPV 88% (95%CI = 0.679-0.979).
Conclusion Lower values of ELR and ENR in patients with NOE are associated with fungal infection and can serve as a tool in adjusting an appropriate antimicrobial therapy in cases of sterile or when no culture is available.
Alan L. Sticker, Sydney T. Cannon, Gregory B. Russell, Joshua D. Waltonen
Publication date 12-04-2024
Abstract Objective To determine the patient and treatment characteristics associated with delay in post-operative radiation therapy (PORT) for patients treated surgically for head and neck squamous cell cancer (HNSCC) at our institution.
Design Single institution retrospective review.
Setting Tertiary care academic medical centre.
Participants Patients treated surgically for HNSCC who underwent PORT between 2013 and 2016.
Main Outcome Measures and Results One hundred forty patients met inclusion criteria. A majority did not start radiotherapy within 6 weeks. Factors associated with a delayed initiation of PORT included length of stay >8 days, 30-day readmission, no adjuvant chemotherapy, post-operative complications and fragmented care.
ConclusionsA majority of patients did not initiate PORT within the guideline-recommended 6 weeks. Modifiable risks factors that delay initiation of PORT were identified.
Ahmed Hassan Sweed, Alsayed Abdulmageed, Ahmed Abdelfattah Bayomy Nofal, Mohammed Elsayed Elmaghawry, Mohamed Abdelmohsen Alnemr
Publication date 12-04-2024
Abstract Introduction To assess the usage of contralateral infrahyoid muscles as onlay flap in prevention of pharyngo-cutaneous fistula (PCF) in total laryngectomy (TL) patients with high risk factors of PCF development.
Methods This study included 10 patients who suffered from advanced laryngeal carcinoma with presence of risk factors for development of PCF. We added an enforcement muscular layer during neo-pharynx wall repair, the infrahyoid muscle flap of the contralateral side of the tumour origin as an onlay muscular flap to cover the anastomotic site for healing augmentation. Patients were followed up for PCF development where the PCF incidence was calculated.
Results One patient died from congestive heart failure in the 21th post-operative day so, the actual PCF rate in TL patients with high risk factors of PCF development in our study was 11.11% (1 out of 9 cases).
Conclusions Infrahyoid muscle flap may have a role in preventing PCF after TL in patients with high risk factors of PCF development in this case series study to be further assessed in other studies to justify its role.
Level of evidence: 4.
Hanqing Lin, Chunli Gao, Yu Heng, Xiaoke Zhu, Tian Wang, Liang Zhou, Ming Zhang, Chunping Wu, Lei Tao
Publication date 10-04-2024
Abstract Objectives To explore the predictive significance of baseline absolute peripheral lymphocyte counts (ALC) in the effectiveness of radiation in hypopharyngeal squamous cell carcinoma (HPSCC) patients.
Design, Setting, and ParticipantsA retrospective study of pathologically confirmed HPSCC patients who had definitive radiation between January 2020 and January 2022 at Fudan University Eye and ENT Hospital. The routine blood results of patients were obtained to determine if the baseline ALC was connected with the response to radiation. The receiver operator characteristic (ROC) curve and LASSO-based Cox regression were employed to assess the predictive value of ALC for the efficacy of radiotherapy (RT).
Main Outcome Measures and ResultsRT induced a considerable drop in ALC and the level of ALC did not revert to the baseline values 1 year after radiation. The baseline level of ALC was higher in patients who met complete response after RT. The baseline ALC and monocyte counts demonstrated the predictive value of radiation effectiveness and ALC was an independent predictor.
Conclusion In HPSCC, lymphocytes were sensitive to radiation and reduced significantly during RT. The baseline ALC might be regarded as a predictive indicator of the effectiveness of RT.
Igor Vainer, Sharon Tzelnick, Noga Kurman, Aron Popovtzer, Ethan Soudry
Publication date 04-04-2024
Abstract Objective The purpose of this study was to investigate whether patient, tumour and radiation therapy factors are associated with development of middle ear effusion (MEE) in nasopharyngeal carcinoma (NPC) patients.
Deign, Settings, and ParticipantsA retrospective review of NPC patients treated between January 2000 and June 2018 at Rabin Medical Center.
Patient factors, tumour factors, radiation doses, and radiation fields were collected and outlined if needed (middle ear, eustachian tube ET, tensor veli palatini TVP, and levator palatini LVP muscles), then analysed and compared between patients with MEE and those without and between sides in patients with unilateral MEE.
Main Outcome Measures and Results Seventy-three patients were enrolled. Most were males (71.2%) with advanced-stage diseases (78%). At the time of diagnosis 14 patients (19.2%) presented with MEE. Following radiation, 18 patients, with no evidence of MEE at presentation, developed MEE. Tumour stage, histology, and laterality were not associated with development of MEE. Comparison of mean radiation field dosages including—gross target volume, clinical target volume, and patient target volume showed no association with post-radiation MEE. In addition, no difference was found in the radiation doses to the middle ear, ET or the LVP nor the TVP between ears with and without MEE.
Conclusions Post-irradiation MEE remains a common adverse effect in NPC patients. Surprisingly, tumour stage, tumour laterality, and histology were not associated with MEE. Similar findings were observed for total radiation doses and specific doses to the middle ear, ET, and ET muscles.
Dimitrios Angelou, Mohd Afiq Mohd Slim, Arunachalam Iyer
Publication date 02-04-2024
Kai Sun, Chao Wang, Shanchun Gong, Haidong Zhang, Siyao Zhang, Huiying Hu, Yuanyuan Lu, Kai Liu, Zhenkun Yu
Publication date 01-04-2024
Abstract Background Laryngeal leukoplakia (LL) is a white lesion with high potential of recurrence and malignant transformation. Currently, CO2 laser has become the primary surgical treatment for LL, and the recurrence and malignant transformation rates after treatment vary widely.
Objective We performed a systematic review and meta-analysis dedicated to evaluating the rates of recurrence and malignant transformation of LL lesions treated with CO2 laser and exploring relevant risk factors for recurrence or malignant transformation.
Methods Literature searches were conducted on Pro Quest, Pub Med, Web of Science, Ovid Medline, Embase, and Cochrane databases. Some articles identified through hand searching were included.
ResultsA total of 14 articles and 1462 patients were included in this review. Pooled results showed that the overall recurrence rate was 15%, and the malignant transformation rate was 3%. Subgroup analysis showed that the dysplasia grade was not a significant risk factor for the recurrence and malignant transformation of LL (P > .05).
Conclusions The results of this systematic review and meta-analysis suggest that the CO2 laser is a safe and effective surgical instrument for the excision of LL, which yields low rates of recurrence and malignant transformation. The risk factors relevant to recurrence or malignant transformation remain unclear and require further investigation.
Muhammad Shahid Iqbal, Malcolm Jackson, Claire Paterson
Publication date 28-03-2024
Abstract Purpose To conduct a comprehensive narrative review of the evidence for radiotherapy target volumes to the neck, after neck dissection, for head and neck squamous cell carcinoma from an unknown primary (HNSCCUP). Inclusion or exclusion of mucosal irradiation is not the focus of interest for this review article.
Materials and Methods Literature (Pub Med-Medline, EMBASE database and Cochrane library) was searched using the relevant keywords. The search results were limited to the studies published in year 2000 or after.
Results Eight studies met the inclusion criteria. All studies were retrospective in nature. The incidence of contralateral recurrence rates in the untreated neck when the involved neck only is treated remains very low (0%–10%). Survival has improved over the past two decades, most likely due to improved diagnostic techniques and the increase in incidence of HPV-related disease.
Conclusion Given the rarity of disease, level one evidence from randomised controlled trials is lacking. Available data are retrospective but support unilateral post-operative radiotherapy as a treatment option in selected cases.
"Helen Pearce, David Hamilton, Linda Sharp, Jennifer Deane, Matthew Kennedy, James OHara"
Publication date 21-03-2024
Kelten Clements, Alekh Thapa, Anna Cowell, David Conway, Catriona M Douglas, Claire Paterson
Publication date 21-03-2024
Abstract Objectives This rapid review aims to evaluate the impact of the COVID-19 pandemic on incidence of head and neck cancer (HNC) and stage distribution at diagnosis.
Design Rapid review and meta-analysis.
Participants Comparative data for new HNC patients between a pre-pandemic cohort (before March 2020) and a pandemic cohort (after March 2020 during the lockdown period).
Main Outcomes Measured Data on tumour stage, incidence, referral pathway (number of new patient referrals), or workload levels (number of HNC treatments). Data on stage were summarised as odds ratios (OR) with 95% confidence intervals (CI), and data related to changes in numbers of diagnoses, referrals, and workload levels were summarised as a narrative synthesis.
ResultsA total of 31 reports were included in this review. Individually 16 out of 23 studies did not show a significant impact on stage relative to the pre-pandemic period. However, the meta-analysis revealed that patients diagnosed with HNC during the pandemic were 16% more likely to have nodal involvement (OR = 1.16; 95% CI 1.00–1.35), 17% more likely to have a late overall stage (OR = 1.17; 95% CI 1.01–1.36), and 32% more likely to present with advanced tumour extent (T3 and T4 stage) (OR = 1.32; 95% CI 1.08–1.62). Data on incidence was extremely limited and not currently sufficient to assess trends in burden of disease.
Conclusions This review indicates that during the COVID-19 pandemic, there was upstaging of HNC at diagnosis, suggesting the provision of care to HNC patients was significantly affected.
A. I. Kaleva, A. Patel, T. Sooriyamoorthy, P. A. Dimitriadis, K. Rajaguru, G. Mochloulis
Publication date 11-03-2024
Jeroen M. Westra, Manon A. Zwakenberg, Gyorgy B. Halmos, Bernard F. A. M. van der Laan, Bert van der Vegt, Boudewijn E. C. Plaat
Publication date 24-02-2024
Abstract Objective To assess whether narrow band imaging (NBI) detects fields of cancerisation around suspicious lesions in the upper aerodigestive tract, which were undetected by white light imaging (WLI).
Methods In 96 patients with laryngeal and pharyngeal lesions suspicious for malignancy, 206 biopsies were taken during laryngoscopy: 96 biopsies of suspicious lesions detected by both WLI and NBI (WLI+/NBI+), 60 biopsies adjacent mucosa only suspicious with NBI (WLI-/NBI+), and 46 biopsies of NBI and WLI unsuspicious mucosa (WLI-/NBI-) as negative controls. Optical diagnosis according to the Ni-classification was compared with histopathology.
Results Signs of (pre)malignancy were found in 88% of WLI+/NBI+ biopsies, 32% of WLI-/NBI+ biopsies and 0% in WLI-/NBI- (p < .001). In 58% of the WLI-/NBI+ mucosa any form of dysplasia or carcinoma was detected.
Conclusion The use of additional NBI led to the detection of (pre)malignancy in 32% of the cases, that would have otherwise remained undetected with WLI alone. This highlights the potential of NBI as a valuable adjunct to WLI in the identification of suspicious lesions in the upper aerodigestive tract.