Atlas on Narrow Band Imaging in Upper Aerodigestive Tract Lesions

By Rakesh Srivastava

This book covers all aspects of narrow band imaging (NBI), including research, general principles and diagnostic features in various ENT pathologies. In addition to highlighting the advantages of NBI over white light endoscopy for the detection of early cancers and lesions that are less than 1 cm in diameter, the book offers a step-by-step approach to help readers easily grasp various pathologies of the upper aerodigestive tract. It discusses both malignant and non-malignant aspects of NBI and provides extensive information on inflammatory lesions of the upper aerodigestive tract, including various clinical features of laryngopharyngeal reflux. Subsequent chapters cover the most difficult aspects of NBI in treated mucosa (post-chemo radiated), in which the potential recurrence of disease is a key question. It also addresses the limitations of NBI, including false positive and false negative cases.

Given its scope, the book will benefit otolaryngologists, oncosurgeons, radiation oncologists and oral medicine practitioners, as well as graduate students of ENT, radiotherapy, oral medicine and oncosurgery.

• Language: English
• Publisher: Springer
• Release date: May 30, 2019
• ISBN: 9789811367489

Book preview

© Springer Nature Singapore Pte Ltd. 2019

Rakesh SrivastavaAtlas on Narrow Band Imaging in Upper Aerodigestive Tract Lesionshttps://doi.org/10.1007/978-981-13-6748-9_1

1. Introduction

Rakesh Srivastava¹ 

(1)

Sushrut Institute of Plastic Surgery Super Specialty Hospital, Lucknow, Uttar Pradesh, India

Head and neck cancers are the sixth most common type of malignancy worldwide. More than 90% of these cancers are squamous cell carcinomas arising from the mucosal surface of the oral cavity, oropharynx, larynx, and laryngopharynx [1]. The global incidence of oral cancers is approximately 500,000 new cases every year. They comprise 3% of all malignancies, with squamous cell carcinoma comprising 96% of all cancers of the oral cavity.

Southeast Asia (especially the Indian subcontinent) is a high-risk region for these cancers. In all, 57.5% of head and neck cancers (excluding esophageal cancers) occur in Asia, especially in India. In India, head and neck cancers account for 30% of all cancers in males and 11–16% of all cancers in females. More than 200,000 new cases of head and neck cancers occur each year in India [2].

Laryngeal cancer accounts for 3–6% of all cancers in men in India [3]. The incidence of laryngeal cancer ranges from 1.26 to 8.18 per 100,000 population across different regions of India. It is one of the ten leading causes of cancer in Indian men. The overall 5-year survival rate for larynx cancer in India is approximately 28%, which is lower than that of China or South Korea.

The initial screening for oral cavity cancer involves visual inspection and palpation. Patients with laryngeal and laryngopharyngeal cancers often present with late-stage disease due to delayed symptomatology, which includes hoarseness of the voice and pain/difficulty on swallowing.

Screening for laryngeal cancer is challenging. Most tests are invasive, either in the form of white-light endoscopy or another optical image enhancement technology. Endoscopic assessment and biopsy remain the gold standards for diagnostic tests. However, these methods have their limitations, particularly in differentiating between benign and malignant lesions.

Advancements have been made in the treatment of oral cancers, but early detection is still not common. Low literacy rates, limited knowledge about the disease, and a lack of awareness about screening programs contribute to very late disease detection on the Indian subcontinent. In Southeast Asia, more than 50% of patients present with advanced-stage disease. The typical survival time for patients with such advanced cases is less than 1 year. However, early cancer detection in high-risk cases can improve the overall survival of