Biopsies showed three of the patients to have dysplasia. All three of the patients had been examined using narrow-band imaging. These numbers were significant (p = 0.03), although there was a small sample size of patients, Dr. O’Brien said.
Explore This IssueDecember 2008
Biopsies showed 15 of the patients to have Barrett’s esophagus-eight of the patients who had been examined using narrow-band imaging and seven of those examined using only white light. That breaks down to 15.1% with narrow-band imaging and 12.1% with white light only.
This was not approaching statistical significance (p = 0.32), Dr. O’Brien said.
Orangeburg, NY-based Olympus Surgical America provided the narrow-band imaging system for the study.
Road to Better Diagnosis
Better diagnosis of patients with laryngopharyngeal reflux could have broad implications, Dr. O’Brien said. And more widespread, and more effective, use of transnasal esophagoscopy is a big part of that, he suggested.
Transnasal esophagoscopy is becoming an increasingly common tool used in our field of otolaryngology, he said. It has been suggested that there is a greater correlation between the symptoms of LPR with the presence of adenocarcinoma than between traditional GERD symptoms with adenocarcinoma.
His study, which is due to appear in Annals of Otology, Rhinology & Laryngology, shows that narrow-band imaging may play a central role in advancements to be made in those critical examinations, Dr. O’Brien said. It allows for greater image clarity, he said. Transnasal esophagoscopy with narrow-band imaging is feasible.
Dr. Parham said that more research should be conducted on the usefulness of narrow-band imaging in esophagoscopy.
Our work implies that with proper tools-for example, narrow-band imaging-sensitivity of transnasal esophagoscopy performed in the ENT office may be increased to potentially detect not just Barrett’s, but also dysplastic changes arising in the background of Barrett’s, he said. Since this study was conducted without true controls, further investigations that involve randomization, patients with known Barrett’s, control group, and blinded endoscopists will serve to verify our findings and further evaluate the utility of narrow-band imaging integrated into transnasal esophagoscopy.
©2008 The Triological Society