Preliminary experiences with contact endoscopy of the larynx

Nine patients with laryngeal polyps, four with Reinke's edema, three with leukoplakia, one with papilloma and one with malignant tumor were studied by means of laryngeal contact endoscopy during microlaryngoscopy. This technique allowed in vivo and in situ visualization of the superficial layer of the laryngeal epithelium after staining with methylene blue. Cell structures evaluated were the size and color of the nuclei, the nucleus/cytoplasm ratio, nuclear and cytoplasmic contours, the presence of nucleoli mitoses and keratoses, as well as the microvascular network of the mucosa and superficial cellular changes from normal to pathological. The normal squamous epithelium of the vocal cord showed a homogeneous cellular population with regular nuclear and cytoplasmic morphological characteristics and a uniform nucleus-to-cytolasm ratio. Specific cellular epithelial patterns and several alterations of the vascular distribution were found in different pathological conditions. Cytological pictures obtained at contact endoscopy were consistent with histological findings in all the patients studied.