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Caroline Boudoux, PhD; Shelby C. Leuin, MD; Wang Yuhl Oh, PhD; Melissa J. Suter, PhD; Adrien E. Desjardins, PhD; Benjamin J. Vakoc, PhD; Brett E. Bouma, PhD; Christopher J. Hartnick, MD; Guillermo J. Tearney, MD, PhD

Arch Otolaryngol Head Neck Surg. 2009;135(1):53-64.

Objectives  To compare and contrast 4 optical imaging techniques for evaluating the developing microstructure of the pediatric vocal fold and to identify the optimal strategy for in vivo imaging.

Design  Prospective study.

Setting  Academic medical center.

Patients  A total of 6 laryngeal specimens: 5 pediatric (ages 10 months to 16 years) (4 from cadavers and 1 from a living patient immediately after laryngectomy) and 1 cadaveric young adult specimen (age, 23 years).

Intervention  Sequential noninvasive optical imaging of pediatric vocal fold specimens using optical frequency domain imaging (OFDI), angle-resolved OFDI (AR-OFDI), spectrally encoded confocal microscopy (SECM), and full-field optical coherence microscopy (FF-OCM), followed by fixation, sectioning, and histologic analysis of the same specimen for comparison.

Main Outcome Measure  Correlation between the microstructure observed using the 4 noninvasive optical imaging techniques and with the results of histopathologic analysis for the same specimen.

Results  A successful in vivo imaging technique for developmental assessment of the pediatric vocal fold would include visualization of distinct layers (epithelium, lamina propria, and muscularis mucosa) and allow for identification of the individual cells composing the layers. The OFDI and AR-OFDI techniques provide a global assessment of the microstructure of the pediatric vocal fold to a depth of 1200 µm but lack the ability to distinguish cellular and subcellular structures. The FF-OCM technique allows for visualization with improved cellular detail (1-µm resolution), but the image acquisition speed is too slow for clinical use. The SECM technique has a faster acquisition rate and shows good cellular and subcellular detail to a depth of 250 µm.

Conclusions  The OFDI and SECM techniques were identified as promising and complementary candidates for in vivo cellular and subcellular imaging of the epithelium, basement membrane, and lamina propria of the pediatric vocal fold. To further validate the clinical potential of these techniques, a handheld SECM probe has been developed and demonstrated for in vivo evaluation of the pediatric vocal fold.

Author Affiliations: Wellman Center for Photomedicine, Massachusetts General Hospital (Drs Boudoux, Oh, Suter, Desjardins, Vakoc, Bouma, and Tearney), and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary (Drs Leuin and Hartnick), Harvard Medical School, Boston; and Division of Health Sciences and Technology, Harvard–Massachusetts Institute of Technology (Drs Boudoux, Desjardins, Bouma, and Tearney), Boston. Dr Boudoux is currently with the École Polytechnique de Montréal, Montréal, Quebec, Canada. Dr Desjardins is currently with Biomedical Photonics Group, Philips Research, Eindhoven, the Netherlands.

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