What is contact endoscopy? How is it done? Describe the normal appearance of larynx by contact endoscopy?
It represent the new phase in the development of endoscopy.
Contact endoscopy is a new method for studying disease of the head and neck which clearly shows the cell morphology of the mucous membrane and the surface vascular network. It allows in viva and in site assessment.
PROCEDURE
Contact endoscopy can be undertaken in either in conscious patient with topical anaesthesia or under general anaesthesia.
It is non-invasive.
2 endoscope are required
7215 AA
7215 BA
With these endoscope the clinician has direct access tothe subsurface microvascular plexus and to the surface epithelium which can be view at magnification of X 60 and X150.
The mucosal surface to be examined is carefully cleaned by
Gentle suction or with
A swab moistened with saline.
The surface is then stained with 1-5% methylene blue applied on a fragment of spongostan.
The tip of endoscope is placed gently against the surface of the mucosa allowing examination.
Staining last around 4-5 minutes at most site before gradually disappearing (Nasal cavity-disappear quick due to mucociliary action)
CONTACT ENDOSCOPY OF LARYNX:
It is performed ↓ GA with conventional endotracheal intubation and synchronous microlaryngoscopy
Vocal cord and hypopharynx is visualized:
Squamous cells have: Polyhedral shape and contiguous with each other.
Nuclei are round and darkly stained cytoplasm has light blue tone.
N:C is regular and overall morphological patterns homogeneous.
Ciliated epithelium is present in most of the larynx
Nuclei are round but the limits of the cytoplasm are difficult to define.
Bundles of cilia appears as filamentous structures that can be displaced by the tips of contact endoscope.
The transition from squamous to ciliated epithelium can be observed.
Island of squamous cell in the middle of ciliated epithelium may be seen ad are not abnormal.
The duct orifices of glances can also be identified.
Protection