Quantitative Evaluation of Adult Subglottic Stenosis Using Intraoperative Long-range Optical Coherence Tomography

Ann Otol Rhinol Laryngol. 2016 Oct;125(10):815-22. doi: 10.1177/0003489416655353. Epub 2016 Jun 28.

Abstract

Objectives: To determine the feasibility of long-range optical coherence tomography (LR-OCT) as a tool to intraoperatively image and measure the subglottis and trachea during suspension microlaryngoscopy before and after endoscopic treatment of subglottic stenosis (SGS).

Methods: Long-range optical coherence tomography of the adult subglottis and trachea was performed during suspension microlaryngoscopy before and after endoscopic treatment for SGS. The anteroposterior and transverse diameters, cross-sectional area (CSA), distance from the vocal cords, and length of the SGS were measured using a MATLAB software. Pre-intervention and postintervention airway dimensions were compared. Three-dimensional volumetric airway reconstructions were generated using medical image processing software (MIMICS).

Results: Intraoperative LR-OCT imaging was performed in 3 patients undergoing endoscopic management of SGS. Statistically significant differences in mean anteroposterior diameter (P < .01), transverse diameter (P < .001), and CSA (P < .001) were noted between pre-intervention and postintervention data. Three-dimensional airway models were viewed in cross-sectional format and via virtual "fly through" bronchoscopy.

Conclusions: This is the first report of intraoperative LR-OCT of the subglottic and tracheal airway before and after surgical management of SGS in humans. Long-range optical coherence tomography offers a practical means to measure the dimensions of SGS and acquire objective data on the response to endoscopic treatment of SGS.

Keywords: airway measurement; direct laryngoscopy; optical coherence tomography; subglottic stenosis; suspension microlaryngoscopy.

MeSH terms

  • Adult
  • Ascorbic Acid
  • Female
  • Ferrous Compounds
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Intraoperative Care
  • Laryngoscopy
  • Laryngostenosis / diagnostic imaging*
  • Laryngostenosis / pathology
  • Laryngostenosis / surgery
  • Larynx / diagnostic imaging*
  • Larynx / pathology
  • Larynx / surgery
  • Organ Size
  • Tomography, Optical Coherence / methods*
  • Trachea / diagnostic imaging*

Substances

  • Ferrous Compounds
  • iron(II)-ascorbic acid complex
  • Ascorbic Acid