Narrow Band Imaging

Abstract

Objective: 1) Investigate a novel technology called narrow band imaging (NBI) in the detection of laryngopharyngeal reflux (LPR). 2) Compare mucosal abnormalities using NBI to conventional fiberoptic white-light laryngoscopy.

Method: A prospective case-control pilot study on the usage of NBI to identify mucosal abnormalities in patients with LPR at a tertiary referral center from July 2010 to February 2011. RFS scores were calculated using white-light endoscopy. NBI was used to characterize endoscopic findings. Video images were reviewed by two blinded laryngologists.

Results: Twelve adult patients with LPR based on RSI scores and 11 normal adult controls were included. Reflux symptom index (RSI) greater than 13 and reflux finding score (RFS) greater than 11 were significantly correlated. NBI findings were graded on 2 vascular patterns and number of laryngeal sites involved. NBI was scored on a scale of 0 to 2 based on degree of color compared with background. Subsites were graded as 1 for 1 subsite and 2 for 2 or more subsites. Higher RFS were associated with lacey and punctuate patterns, as well as increased number of laryngeal sites involved.

Conclusion: This pilot study has demonstrated various vascularity and morphologic patterns in mucosa visualized on NBI examination of patients with LPR. Preliminary results indicate that NBI may be a useful aid in the diagnosis of LPR, but a larger study size and standardized methods of quantification of LPR changes are recommended.