Capabilities of optical coherence tomography in laryngology

We present first results of using the optical coherence tomography (OCT) in complex clinical studies in laryngology. Mucose of the upper and middle portions of larynx is of special interest for OCT applications: it is clinically important, easily accessed by an endoscopic OCT probe, and possesses a well defined and rich tomographic structure. We have examined several tens of patients with abnormalities in vocal folds. The diagnosis was made based on clinical data including laryngoscopy and finally confirmed morphologically. When examining larynx mucose, an endoscopic OCT probe has been introduced through a standard laryngoscope lumen, so that OCT imaging has been performed in parallel with visual observation. The OCT studies have demonstrated that in comparison with stratified healthy mucosa, carcinomatous regions have no tomographically differentiated structure, thus allowing one to exactly define the border of a tumor. Vocal nodules are imaged as poorly scattering regions without clear boundaries under preserved epithelium. Cysts of gland mucose are seen with OCT as sharply delineated shadows at the depth of several hundred micrometers. We have also examined several patients with carcinoma after a course of radiation therapy and observed different changes in OCT images of adjoining epithelium corresponding to metaplasia, hyperplasia, and sclerosis.