Transcript Diagnostic progress or false evidence by in-vivo contact
Slide 1
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 2
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 3
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 4
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 5
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 6
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 7
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 8
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 9
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 10
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 2
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 3
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 4
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 5
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 6
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 7
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 8
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 9
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Slide 10
HELIOS Klinik Borna
Diagnostic progress or false
evidence by in-vivo contact
endoscopy – a critical point of
view
Th. Wilhelm
Dept. Otolaryngology,
Head/Neck & Facial Plastic Surgery
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Development of contact endoscopy
• 1979
J.E. Hamou
Paris
• 1995/1997
M. Andrea &
O. Dias
Lissabon
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Patient‘s characteristics
• n = 13 (10 ♀, 3 ♂)
• mean age = 45 y, (range: 24,6 – 66,8)
leukoplacia/cancer
23%
functional disorder
(dysgeusia, dysphagia,
dysphonia, paralysis)
47%
HELIOS Klinik Borna
granulation tissue
15%
acute/chronic
inflammation
15%
21.01.2006
© Th. Wilhelm
Methods - technique
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods – criteria of evaluation
• nucleus/plasma-relation
• dysplasia of nuclei
3
1
2
• polychromasia of
cover epithelium
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Methods
1.
4.
Staining with methylenblue 1% , 3,5 minutes:
2.
3.
HELIOS Klinik Borna
biopsy
21.01.2006
© Th. Wilhelm
Results – vessel architecture
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Results – case 1
vessel diameter 74,2 µm
HELIOS Klinik Borna
erythrocyt = nuleus (7 µm)
21.01.2006
© Th. Wilhelm
Results – case 2
♀ 46 y, granulation tissue at the
vocal process of the arytaenoid cartilage
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm
Conclusion
1. Cell nuclei and their morphologic changes
could not be represented.
2. Contact endoscopy can not replace
histopathological examination yet.
HELIOS Klinik Borna
21.01.2006
© Th. Wilhelm