Vascular evaluation in laryngeal diseases: comparison between contact endoscopy and laser Doppler flowmetry.

OBJECTIVE

To determine the efficacies of 2 methods for evaluating vascular changes in laryngeal diseases.

DESIGN

Prospective comparative study.

SETTING

University hospital.

PATIENTS: Twenty-four adults planning to undergo laryngomicrosurgery for unilateral lesions in their vocal cords.

INTERVENTION: Vascular evaluation was performed using contact endoscopy and laser Doppler flowmetry during laryngomicrosurgery.

MAIN OUTCOME MEASURES: Morphological and physiological variables of the vascular changes.

RESULTS

Contact endoscopy examinations revealed changes in the fine vascular network patterns in the vocal cords. Hypervascularity was present in patients with polyps but not in those with nodules, and the degree of vascularity was variable in patients with malignant neoplasms. Patients with papillomas and patients in the postradiation therapy group showed hypovascularity with losses in the capillary network. Laser Doppler flowmetry revealed high mean blood flows in patients with polyps, dysplasia, and malignant neoplasms, whereas patients with papillomas and those in the postradiation therapy group had low blood flows. The variables measured by laser Doppler flowmetry and endoscopy were strongly correlated.

CONCLUSION

Evaluations of morphological and physiological changes of vascularity in laryngeal diseases are important for understanding their pathophysiology, and combining contact endoscopy and laser Doppler flowmetry is useful in such evaluations.