Effect of Chromoendoscopy Filters on Visualization of KTP Laser–Associated Tissue Changes: A Cadaveric Animal Model

Abstract

Standard KTP laser (potassium titanyl phosphate) wavelength-specific protective eyewear often impairs visualization of tissue changes during laser treatment. This sometimes necessitates eyewear removal to evaluate tissue effects, which wastes time and poses safety concerns. The objective was to determine if “virtual” or “electronic” chromoendoscopy filters, as found on some endoscopy platforms, could alleviate the restricted visualization inherent to protective eyewear. A KTP laser was applied to porcine laryngeal tissue and recorded via video laryngoscopy with 1 optical (Olympus Narrow Band Imaging) and 8 digital (Pentax Medical I-scan) chromoendoscopy filters. Videos were viewed by 11 otolaryngologists wearing protective eyewear. Using a discrete visual analog scale, they rated each filter on its ability to improve visualization,. No filter impaired visualization; 5 of 9 improved visualization. Based on statistical significance, the number of positive responses, and the lack of negative responses, narrow band imaging and the I-scan tone enhancement filter for leukoplakia performed best. These filters could shorten procedure time and improve safety; therefore, further clinical evaluation is warranted.

Keywords

KTP laser in-office surgery virtual chromoendoscopy electronic chromoendoscopy narrow band imaging i-scan protective eyewear

Get full access to this article

View all access options for this article.

References

Teichman

Vassar

Yates

et al . Color vision deficits and laser eyewear protection for soft tissue laser applications. J Urol. 1999;161:874-880.

Ellis

Foden

Han

et al . Improved visualisation of blood while wearing KTP laser protective eyewear using digital manipulation of endoscopic images: seventeen surgeons experience on simulation testing. Clin Otolaryngol. 2013;38:438-442.

Park

Herbert

EN.

Laser goggles alter the perceived colour of drug labels, increasing the risk for drug errors. Can J Ophthalmol. 2013;48:e27-e28.

Piazza

Cocco

Del Bon

et al . Narrow band imaging and high definition television in the endoscopic evaluation of upper aero-digestive tract cancer. Acta Otorhinolaryngol Ital. 2011;31:70-75.

Tontini

Vecchi

Neurath

et al . Review article: newer optical and digital chromoendoscopy techniques vs dye-based chromoendoscopy for diagnosis and surveillance in inflammatory bowel disease. Aliment Pharmacol Ther. 2013;38:1198-1208.

Kodashima

Fujishiro

Novel image-enhanced endoscopy with i-scan technology. World J Gastroenterol. 2010;16:1043-1049.

Mallur

Johns

3rd Amin

et al . Proposed classification system for reporting 532-nm pulsed potassium titanyl phosphate laser treatment effects on vocal fold lesions. Laryngoscope. 2014;124:1170-1175.

Kraft

Fostiropoulos

Gurtler

et al . Value of narrow band imaging in the early diagnosis of laryngeal cancer. Head Neck. 2016;38:15-20.

Ochsner

Klein

AM.

The utility of narrow band imaging in the treatment of laryngeal papillomatosis in awake patients. J Voice. 2015;29:349-351.

10.

Dippold

Becker

Nusseck

et al . Narrow band imaging: a tool for endoscopic examination of patients with laryngeal papillomatosis. Ann Otol Rhinol Laryngol. 2015;124:886-892.

11.

van der Heijden

Hoefsloot

van Hees

et al . High definition bronchoscopy: a randomized exploratory study of diagnostic value compared to standard white light bronchoscopy and autofluorescence bronchoscopy. Respir Res. 2015;16:33.

12.

Hoffman

Korczynski

Tresch

et al . Acetic acid compared with i-scan imaging for detecting Barrett’s esophagus: a randomized, comparative trial. Gastrointest Endosc. 2014;79:46-54.

13.

Kang

Hong

Kim

et al . The efficacy of i-SCAN for detecting reflux esophagitis: a prospective randomized controlled trial. Dis Esophagus. 2013;26:204-211.