Robert Šifrer
1: Šifrer R, Urbančič J, Piazza C, van Weert S, García-Purriños F, Benedik J, Tancer I, Aničin A. Emergent tracheostomy during the pandemic of COVID-19: Slovenian National Recommendations. Eur Arch Otorhinolaryngol. 2021 Jul;278(7):2209-2217. doi: 10.1007/s00405-020-06318-8. Epub 2020 Sep 5. PMID: 32889621; PMCID: PMC7473826.
2: Šifrer R, Benedik J, Aničin A. Elective open "Shield Tracheostomy" in patients with COVID-19. Eur Arch Otorhinolaryngol. 2022 Feb;279(2):891-897. doi: 10.1007/s00405-021-06820-7. Epub 2021 Apr 21. PMID: 33881578; PMCID: PMC8059421.
3: Šifrer R, Strojan P, Tancer I, Dolenc M, Fugina S, Zore SB, Aničin A. The Incidence and the Risk Factors for Pharyngocutaneous Fistula following Primary and Salvage Total Laryngectomy. Cancers (Basel). 2023 Apr 12;15(8):2246. doi: 10.3390/cancers15082246. PMID: 37190174; PMCID: PMC10136624.
4: Šifrer R, Aničin A, Pohar MP, Žargi M, Pukl P, Soklič T, Strojan P. Pharyngocutaneous fistula: the incidence and the risk factors. Eur Arch Otorhinolaryngol. 2016 Oct;273(10):3393-9. doi: 10.1007/s00405-016-3963-z. Epub 2016 Mar 8. PMID: 26956981.
5: Šifrer R, Dolenc M, Zore SB, Fugina S, Jesenko L, Strojan P. Temporal Variability in the Incidence and Risk Factors for Pharyngocutaneous Fistula Development after Total Laryngectomy. Cancers (Basel). 2024 Oct 15;16(20):3486. doi: 10.3390/cancers16203486. PMID: 39456580; PMCID: PMC11506730.
6: Šifrer R, Rijken JA, Leemans CR, Eerenstein SEJ, van Weert S, Hendrickx JJ, Bloemena E, Heuveling DA, Rinkel RNPM. Evaluation of vascular features of vocal cords proposed by the European Laryngological Society. Eur Arch Otorhinolaryngol. 2018 Jan;275(1):147-151. doi: 10.1007/s00405-017-4791-5. Epub 2017 Oct 30. PMID: 29086006; PMCID: PMC5754403.
7: Šifrer R, Šereg-Bahar M, Gale N, Hočevar-Boltežar I. The diagnostic value of perpendicular vascular patterns of vocal cords defined by narrow-band imaging. Eur Arch Otorhinolaryngol. 2020 Jun;277(6):1715-1723. doi: 10.1007/s00405-020-05864-5. Epub 2020 Feb 28. PMID: 32112142.
8: Sifrer R, Strojan P, Zidar N, Zargi M, Groselj A, Krajinovic M. Distant metastasis of rectal adenocarcinoma in a temporary tracheostoma. Radiol Oncol. 2014 Nov 5;48(4):393-6. doi: 10.2478/raon-2013-0079. PMID: 25435853; PMCID: PMC4230560.
9: Šifrer R, Urbančič J, Strojan P, Aničin A, Žargi M. The assessment of mucosal surgical margins in head and neck cancer surgery with narrow band imaging. Laryngoscope. 2017 Jul;127(7):1577-1582. doi: 10.1002/lary.26405. Epub 2016 Nov 15. PMID: 27859314.
10: Jensterle S, Benedik J, Sifrer R. Tracheostomy before and during COVID-19 pandemic. Radiol Oncol. 2024 Jun 12;58(4):556-564. doi: 10.2478/raon-2024-0034. PMID: 38861690; PMCID: PMC11604258.
Session
Background/Objectives: Narrow Band Imaging (NBI) endoscopy is a relatively novel optical biological endoscopic method that enables improved visualization of microvascular patterns and thus, earlier detection of vocal cord cancer. The purpose of this instructional course is to present the diagnostic value of NBI and compare the most commonly used classifications of microvascular patterns.
Methods: The literature was reviewed and our own clinical experience in the use of NBI and enhanced contact endoscopy using NBI were incorporated with an emphasis on Ni's classification and the classification of the European Laryngology Society (ELS) and Puxeddu’s classification.
Results: NBI allows for the precise visualization of mucosal and submucosal vessels and the detection of pathological microvascular patterns associated with malignant transformation. Ni's classification offers a detailed, but complex classification that requires a high level of training. The ELS classification is simpler, based on the dichotomous division of vascular changes into longitudinal and perpendicular ones, allowing for the effective and straightforward differentiation between benign and malignant changes as well as rapid learning. Puxeddu’s classification is intended for use with contact endoscopes coupled to NBI device and high-resolution monitors. Although complex, it provides highly informative clinical data.
Conclusions: NBI is a non-invasive, swift, reliable endoscopic method for the early detection of vocal cord cancer. For optimal results, both profound understanding of microvascular patterns and two-step endoscopic diagnostic procedure are of paramount importance.