TY - JOUR
T1 - Identifying epithelial borders in cholesteatoma surgery using narrow band imaging
AU - Baazil, Adrianus H. A.
AU - Eggink, Maura C.
AU - de Wolf, Maarten J. F.
AU - Ebbens, Fenna A.
AU - Dikkers, Frederik G.
AU - van Spronsen, Erik
N1 - Funding Information: The authors would like to thank the following 16 otologic surgeons for their participation in this study: dr. F.B. van der Beek, Medisch Spectrum Twente, Enschede; drs. A.J.F. Beerens, Vijf Meren Kliniek, Haarlem; drs. J.W.M. Bok, Flevoziekenhuis, Almere; dr. A.J.G. de Bruijn, Ziekenhuis Groep Twente, Almelo; dr. D.R. Colnot, Diakonessenhuis, Utrecht; drs. C. Jolink, Acibadem, Amsterdam; drs. R.M. van Haastert, Dijklander Ziekenhuis, Purmerend; dr. A.M. Kreeft, Ziekenhuis Amstelland, Amstelveen; drs. E.E. Kummer, Zaans Medisch Centrum, Zaandam; drs. P.G.B. Mirck, non-practising; drs. F.A.W. Peek, Reinier de Graaf Gasthuis, Delft; dr. R. Hoffmans, OLVG, Amsterdam; dr. M. van der Torn, Dijklander Ziekenhuis, Hoorn; drs. H.F. van Waegeningh, Tergooi, Blaricum; dr. B.O. Westerlaken, Medisch Spectrum Twente, Enschede and dr. J.W. Zwartenknot, Sint Antonius Ziekenhuis, Nieuwegein. We would also like to thank the Heinsius Houbolt fund for their research grant. Publisher Copyright: © 2021, The Author(s).
PY - 2021
Y1 - 2021
N2 - Purpose: To quantify changes in the perceived epithelial border with narrow band imaging (NBI) and white light imaging (WLI) during cholesteatoma surgery and to objectify possible benefits of NBI in otology. Methods: Perioperative digital endoscopic images were captured during combined approach tympanoplasty at our tertiary referral center using WLI and NBI (415 nm and 540 nm wavelengths). Sixteen otologic surgeon defined the epithelial borders within 16 identical WLI and NBI photos. Pixels of these selections were calculated to analyze the quantitative difference between WLI and NBI. A questionnaire also analyzed the qualitative differences. Results: Sixteen otologic surgeons participated in the study. Stratified per photo, only two photos yielded a significant difference: less pixels were selected with NBI than WLI. A Bland–Altman plot showed no systemic error. Stratified per otologist, four participants selected significantly more pixels with WLI than with NBI. Overall, no significant difference between selected pixels was found. Sub-analyses of surgeons with more than 5 years of experience yielded no additional findings. Despite these results, 60% believed NBI could be advantageous in defining epithelial borders, of which 83% believed NBI could reduce the risk of residual disease. Conclusion: There was no objective difference in the identification of epithelial borders with NBI compared to WLI in cholesteatoma surgery. Therefore, we do not expect the use of NBI to evidently decrease the risk of residual cholesteatoma. However, subjective assessment does suggest a possible benefit of lighting techniques in otology. Level of evidence: 3.
AB - Purpose: To quantify changes in the perceived epithelial border with narrow band imaging (NBI) and white light imaging (WLI) during cholesteatoma surgery and to objectify possible benefits of NBI in otology. Methods: Perioperative digital endoscopic images were captured during combined approach tympanoplasty at our tertiary referral center using WLI and NBI (415 nm and 540 nm wavelengths). Sixteen otologic surgeon defined the epithelial borders within 16 identical WLI and NBI photos. Pixels of these selections were calculated to analyze the quantitative difference between WLI and NBI. A questionnaire also analyzed the qualitative differences. Results: Sixteen otologic surgeons participated in the study. Stratified per photo, only two photos yielded a significant difference: less pixels were selected with NBI than WLI. A Bland–Altman plot showed no systemic error. Stratified per otologist, four participants selected significantly more pixels with WLI than with NBI. Overall, no significant difference between selected pixels was found. Sub-analyses of surgeons with more than 5 years of experience yielded no additional findings. Despite these results, 60% believed NBI could be advantageous in defining epithelial borders, of which 83% believed NBI could reduce the risk of residual disease. Conclusion: There was no objective difference in the identification of epithelial borders with NBI compared to WLI in cholesteatoma surgery. Therefore, we do not expect the use of NBI to evidently decrease the risk of residual cholesteatoma. However, subjective assessment does suggest a possible benefit of lighting techniques in otology. Level of evidence: 3.
KW - Cholesteatoma surgery
KW - Epithelial border
KW - Narrow band imaging
KW - Residual disease
UR - http://www.scopus.com/inward/record.url?scp=85113441274&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00405-021-07045-4
DO - https://doi.org/10.1007/s00405-021-07045-4
M3 - Article
C2 - 34420082
SN - 0937-4477
JO - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS)
JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS)
ER -