<i>Introduction:</i> Endoscopic imaging can be used in the assessment of cancer and precancerous lesions of the upper aerodigestive tract. The objective of this presentation is to describe vertical imaging methods. <i>Methods:</i> The working principle and technique of optical coherence tomography (OCT) as well as endosonography (EUS) are briefly illustrated. <i>Results:</i> The main indications, normal and pathologic findings of each method, frequent pitfalls, and clinical results up to now are presented in detail. <i>Conclusions:</i> Endosonography helps in determining the exact extension of advanced carcinomas beyond 3 mm, while OCT, due to its better resolution, is superior in the assessment of precancerous and early cancerous lesions up to 2 mm thickness.
Optical coherence tomography (OCT) is a promising method in the early diagnosis of oral cavity cancer. The objective of the present study is to determine normal values of epithelial
thickness in the oral cavity, as no such data are to be found in the literature. In healthy test persons, epithelial thickness of the oral mucosa was determined with the help of OCT separately
for each side at nine different locations. Special attention was directed to those sites having the highest incidence for the development of dysplasias and carcinomas. Depending
on the location within the oral cavity, the epithelium demonstrated a varying thickness. The highest values were found in the region of the tongue and the cheek, whereas the floor of the
mouth showed the thinnest epithelium. Our data serve as reference values for detecting oral malignancy and determining the approximate grade of dysplasia. In this circumstance, a differentiated
view of the different regions is important due to the variation in thickness of the epithelium within the normal oral cavity.
We developed a laryngoscope with an integrated OCT beam path for office-based non-contact imaging of human
vocal folds. In combination with conventional videolaryngoscopy superficial and subsurface lesions can be detected.
For error-free interpretation of OCT images obtained in office-based examination motion artifacts have
to be considered. To demonstrate the implications on OCT images we simulated probe and patient movements
for different commercial systems representing the three OCT modalities and analyzed the OCT data. Our results
show that time domain and fourier domain OCT with a swept light source are probably better suited for noncontact
imaging of awake patients than the current generation of fourier domain OCT engines with spectrometer
Optical coherence tomography (OCT) is a new promising imaging modality in laryngology as yet of undetermined
value. The objective of the present study was to evaluate the ability of this noninvasive method to make a reliable
prediction of diagnosis in laryngeal disease. In a prospective study, 225 benign and malignant laryngeal lesions were
examined with a fiber-based OCT system in contact mode during elective microlaryngoscopy. Intraoperative OCT
findings were compared to conventional histopathology supplying a correct specific diagnosis in about 90% of cases.
With increasing experience, a reliable prediction of invasive tumor growth and often the exact grade of dysplasia were
possible. Due to the current spatial resolution of OCT, microinvasive cancer could not be safely delineated from severe
dysplasia or carcinoma in situ. In contrast, benign lesions made no essential diagnostic difficulties due to their characteristic
OCT image. In conclusion, OCT has proved to be very useful in the diagnostic investigation and the intraoperative
monitoring of laryngeal disease.