“湖路标志”:追踪声沟的另一种方式

G. Desuter, Delphine de Cock de Rameyen, Donatienne Boucquey
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引用次数: 1

摘要

数字A:使用尖端芯片ENF-VT视频镜(Olympus, Inc.;Hamburg,Germany)的直接喉镜检查显示左侧声带上有一个湖路信号(白线),没有使用NBI技术。B:在直接喉镜下用抹刀探查喉袋,可见左侧声带沟。C:插图显示了内窥镜图像与湖泊周围道路的相似性。最近出现的尖端芯片柔性内窥镜允许仔细观察上皮下血管化模式。最近的文献主要集中在声带恶性病变的早期检测及其与良性喉乳头状瘤病的鉴别诊断。这一努力是为了指导——如果不能避免的话——声带活检,创造一种从活检诊断到“照片诊断”的范式转变!然而,这种趋势也可能有利于良性病变的诊断,如声沟。声沟的特征是粘膜下基质的消失,导致上皮内陷,并与下层固有层的不同层有不同程度的粘附。粘膜的“口袋化”迫使在基质中前进的传入血管绕道而行。垂直于间隙的传入血管通常会分成两个血管,绕过间隙边缘。我们称其为“湖路标志”,指的是与湖泊相邻的道路相同的现象(图)。假设,湖路标志也可以适用于粘膜桥,尽管这从未被作者看到。有了新的灵活的内窥镜图像增强技术,这种迹象比以前更容易被发现。或许,窄带成像(NBI)可以提高湖泊道路标志检测的准确性;然而,这仍然是未知的,应该在未来进行研究。同样,未来的研究应该将沟诊断的特异性和敏感性与湖路标志进行比较,并将其与频闪检查结果进行比较。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The “Lake Road Sign”: Another Way to Track the Sulcus Vocalis
Figure. A: Direct laryngoscopy utilizinga chip-on-the-tip ENF-VT videoscope (Olympus, Inc.;Hamburg,Germany)showsa lakeroadsignvessel (whitearrow) on the left vocal fold without the use of NBI technology. B: Probing the pocket with a spatula under direct laryngoscopy demonstrates the presence of a left vocal fold sulcus vocalis. C: Illustration shows the similarity of the endoscopy images to roads skirting lakes. The recent emergence of the chip-onthe-tip flexible endoscope allows careful observation of subepithelial vascularization patterns. Recent literature has focused primarily on early detection of malignant lesions of the vocal folds and their differential diagnosi s with benign laryngeal papillomatosis. This effort is an attempt to guide-s-if not avoid-vocal fold biopsy, creating a paradigm shift from biopsy diagnosis to "photo diagnosis"!" Nevertheless, this trend could also be beneficial for the diagnosis of benign lesions, such as sulcus vocalis. A sulcus vocalis is characterized by the disappearance of the submucosal matri x, leading to an epithelial invagination associated with various degrees of adherence to the different layers of the underlying lamina propria. This "pocketing" of the mucosa forces the afferent vessels, progressing in the matrix , to make a detour. The afferent vessel that is perpendicular to the gap will usually split into two vessels, skirting the gap edges. We called this a "lake road sign:' referring to the same phenomenon that characterizes roads hitting lakes and skirting them (figure). Hypothetically, the lake road sign could be applicable to mucosal bridges, as well, although this has never been seen by the authors. With the new flexible endoscopy image-enhancing technologies that are available, this sign is much easier to notice than it was before. Perhaps narrow-band imaging (NBI) could add accuracy to the detection of lake road signs; however, this is still unknown and should be investigated in the future. Likewise, future studies should compare the specificity and sensitivity for sulcus diagnosis with the lake road sign and compare it to stroboscopy results.
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