Abstract
Confocal endomicroscopy is an emerging technique for intravital visualization of neoplastic lesions, but its use has so far been limited to the gastrointestinal (GI) tract. This study was designed to assess the feasibility of in vivo confocal endomicroscopy of different regions of the oropharyngeal mucosa and to evaluate different contrast agents. We examined five different regions of the human oropharynx in vivo, and images were collected in real time by using a confocal laser endoscope as formerly described for the GI tract. Additionally ex vivo specimens were examined using a topical contrast agent. Confocal scanning was performed at 488-nm illumination for excitation of exogenously applied fluorophores (topical acriflavine and intravenous fluorescein). Confocal endomicroscopy allowed for visualization of cellular and subcellular structures of the anterior human oropharyngeal region. Fluorescein staining yielded architectural details of the surface epithelium and also subepithelial layers. Images taken at increasing depth beneath the epithelium showed the mucosal capillary network. Acriflavine strongly contrasted the cell nuclei of the surface epithelium. The findings correlated well with the histology of biopsy specimens. This is the first report showing that the use of fluorescence confocal endomicroscopy represents a promising method to examine cellular details in vivo in different oropharyngeal regions in human.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Wright SJ, Wright DJ (2002) Introduction to confocal microscopy. Methods Cell Biol 70:1–85
Kiesslich R, Goetz M, Burg J et al (2005) Diagnosing Helicobacter pylori in vivo by confocal laser endoscopy. Gastroenterology 128(7):2119–2123
Polglase AL, McLaren WJ, Skinner SA et al (2005) A fluorescence confocal endomicroscope for in vivo microscopy of the upper- and the lower-GI tract. Gastrointest Endosc 62(5):686–695
Kiesslich R, Hoffman A, Goetz M et al (2006) In vivo diagnosis of collagenous colitis by confocal endomicroscopy. Gut 55(4):591–592
Kiesslich R, Burg J, Vieth et al (2004) Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo. Gastroenterology 127(3):706–713
Deinert K, Kiesslich R, Vieth M et al (2007) In vivo microvascular imaging of early squamous-cell cancer of the esophagus by confocal laser endomicroscopy. Endoscopy 39(4):366–368
Goetz M, Hoffman A, Galle PR et al (2006) Confocal laser endoscopy: new approach to the early diagnosis of tumors of the esophagus and stomach. Future Oncol 2(4):469–476
Pech O, Rabenstein T, Manner H et al (2008) Confocal laser endomicroscopy for in vivo diagnosis on early squamous cell carcinoma in the esophagus. Clin Gastroenterol Hepatol 6(1):89–94
Thong PS, Olivo M, Kho K et al (2007) Laser confocal endomicroscopy as a novel technique for fluorescence diagnostic imaging of the oral cavity. J Biomed Opt 12(1):014007
Goetz M, Kiesslich R, Dienes H et al (2008) In vivo confocal laser endomicroscopy of the human liver: a novel method to assess liver microarchitecture in real time. Endoscopy 40(7):554–562
Just T, Pau HW, Witt M et al (2006) Contact endoscopic comparison of morphology of human fungiform papillae of healthy subjects and patients with transected chorda tympani nerve. Laryngoscope 116(7):1216–1222
Jennings BL, Matthews DE (1994) Adverse reactions during retinal fluorescein angiography. J Am Optom Assoc 65(7):465–471
Acknowledgments
This study was supported by a grant from MAIFOR, Johannes Gutenberg University of Mainz, Germany. We thank Dr. Torsten Hansen, Institute for Pathology, Johannes Gutenberg University, Mainz, Germany for providing the histological images.
Conflict of interest statement
The authors indicate that they do not have a financial relationship with the organization that sponsored the research.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Haxel, B.R., Goetz, M., Kiesslich, R. et al. Confocal endomicroscopy: a novel application for imaging of oral and oropharyngeal mucosa in human. Eur Arch Otorhinolaryngol 267, 443–448 (2010). https://doi.org/10.1007/s00405-009-1035-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-009-1035-3