The Utility of Narrow Band Imaging in the Treatment of Laryngeal Papillomatosis in Awake Patients

Objective. To determine the value of narrow band imaging (NBI) in visualizing laryngeal papillomatosis (LP), specifically in the awake patient. Study Design. Retrospective chart review followed by trial of intervention. Methods. Ten patients treated for LP in the awake setting were included in the study. Still shots of the same diseased region of the larynx were taken from each procedure, one under white light and one under NBI. The 10 pairs of pictures were then sent to multiple fellowship-trained laryngologists, along with a questionnaire designed to evaluate visualization with NBI versus white light. Results. Raters concluded that NBI improved visualization of diseased tissue 90.0% of the time and showed areas of diseased tissue unappreciated by halogen light in 46.7% of the procedures. They believed that NBI better defined the borders of diseased tissue in 76.7% of the photo sets, and that in 70.0% of the sets, NBI was the better visualization technique in general. However, it was found that 16.7% of the time it was more difficult to visualize areas of diseased tissue with NBI. Conclusion. This study suggests that NBI may provide some benefit in the visualization and treatment of LP in the awake patient. Further work should be done to evaluate its utility in pathology of the larynx.