OBJECTIVES/HYPOTHESIS: High-resolution optical imaging is an imaging modality that allows visualization of structural changes in epithelial tissue in real time. Our prior studies using contrast-enhanced microendoscopy to image squamous cell carcinoma in the head and neck demonstrated that the contrast agent, proflavine, has high affinity for keratinized tissue. Thus, high-resolution microendoscopy with proflavine provides a potential mechanism to identify ectopic keratin production, such as that associated with cholesteatoma formation, and distinguish between uninvolved mucosa and residual keratin at the time of surgery. STUDY DESIGN: Ex vivo imaging of histopathologically confirmed samples of cholesteatoma and uninvolved middle ear epithelium. METHODS: Seven separate specimens collected from patients who underwent surgical treatment for cholesteatoma were imaged ex vivo with the fiberoptic endoscope after surface staining with proflavine. Following imaging, the specimens were submitted for hematoxylin and eosin staining to allow histopathological correlation. RESULTS: Cholesteatoma and surrounding middle ear epithelium have distinct imaging characteristics. Keratin-bearing areas of cholesteatoma lack nuclei and appear as confluent hyperfluorescence, whereas nuclei are easily visualized in specimens containing normal middle ear epithelium. Hyperfluorescence and loss of cellular detail is the imaging hallmark of keratin, allowing for discrimination of cholesteatoma from normal middle ear epithelium. CONCLUSIONS: This study demonstrates the feasibility of high-resolution optical imaging to discriminate cholesteatoma from uninvolved middle ear mucosa based on the unique staining properties of keratin. Use of real-time imaging may facilitate more complete extirpation of cholesteatoma by identifying areas of residual disease. Laryngoscope, 2012.
OBJECTIVES/HYPOTHESIS: High-resolution optical imaging is an imaging modality that allows visualization of structural changes in epithelial tissue in real time. Our prior studies using contrast-enhanced microendoscopy to image squamous cell carcinoma in the head and neck demonstrated that the contrast agent, proflavine, has high affinity for keratinized tissue. Thus, high-resolution microendoscopy with proflavine provides a potential mechanism to identify ectopic keratin production, such as that associated with cholesteatoma formation, and distinguish between uninvolved mucosa and residual keratin at the time of surgery. STUDY DESIGN: Ex vivo imaging of histopathologically confirmed samples of cholesteatoma and uninvolved middle ear epithelium. METHODS: Seven separate specimens collected from patients who underwent surgical treatment for cholesteatoma were imaged ex vivo with the fiberoptic endoscope after surface staining with proflavine. Following imaging, the specimens were submitted for hematoxylin and eosin staining to allow histopathological correlation. RESULTS:Cholesteatoma and surrounding middle ear epithelium have distinct imaging characteristics. Keratin-bearing areas of cholesteatoma lack nuclei and appear as confluent hyperfluorescence, whereas nuclei are easily visualized in specimens containing normal middle ear epithelium. Hyperfluorescence and loss of cellular detail is the imaging hallmark of keratin, allowing for discrimination of cholesteatoma from normal middle ear epithelium. CONCLUSIONS: This study demonstrates the feasibility of high-resolution optical imaging to discriminate cholesteatoma from uninvolved middle ear mucosa based on the unique staining properties of keratin. Use of real-time imaging may facilitate more complete extirpation of cholesteatoma by identifying areas of residual disease. Laryngoscope, 2012.
Authors: Peter M Vila; Chan W Park; Mark C Pierce; Gregg H Goldstein; Lauren Levy; Vivek V Gurudutt; Alexandros D Polydorides; James H Godbold; Marita S Teng; Eric M Genden; Brett A Miles; Sharmila Anandasabapathy; Ann M Gillenwater; Rebecca Richards-Kortum; Andrew G Sikora Journal: Ann Surg Oncol Date: 2012-04-11 Impact factor: 5.344
Authors: K P Ananthapadmanabhan; A Lips; C Vincent; F Meyer; S Caso; A Johnson; K Subramanyan; M Vethamuthu; G Rattinger; D J Moore Journal: Int J Cosmet Sci Date: 2003-06 Impact factor: 2.970
Authors: Ralf Kiesslich; Juergen Burg; Michael Vieth; Janina Gnaendiger; Meike Enders; Peter Delaney; Adrian Polglase; Wendy McLaren; Daniela Janell; Steven Thomas; Bernhard Nafe; Peter R Galle; Markus F Neurath Journal: Gastroenterology Date: 2004-09 Impact factor: 22.682
Authors: Timothy J Muldoon; Mark C Pierce; Dawn L Nida; Michelle D Williams; Ann Gillenwater; Rebecca Richards-Kortum Journal: Opt Express Date: 2007-12-10 Impact factor: 3.894
Authors: Timothy J Muldoon; Darren Roblyer; Michelle D Williams; Vanda M T Stepanek; Rebecca Richards-Kortum; Ann M Gillenwater Journal: Head Neck Date: 2011-03-16 Impact factor: 3.147
Authors: Guillermo L Monroy; Wenzhou Hong; Pawjai Khampang; Ryan G Porter; Michael A Novak; Darold R Spillman; Ronit Barkalifa; Eric J Chaney; Joseph E Kerschner; Stephen A Boppart Journal: Otolaryngol Head Neck Surg Date: 2018-03-27 Impact factor: 3.497
Authors: Eric L Wisotzky; Philipp Arens; Steffen Dommerich; Anna Hilsmann; Peter Eisert; Florian C Uecker Journal: Biomed Opt Express Date: 2020-02-20 Impact factor: 3.732
Authors: Guillermo L Monroy; Jungeun Won; Roshan Dsouza; Paritosh Pande; Malcolm C Hill; Ryan G Porter; Michael A Novak; Darold R Spillman; Stephen A Boppart Journal: NPJ Digit Med Date: 2019-03-28