Immunology

Biography

Biography: Daniel G. Rey Caro

Abstract

This work has been presented in several national and international ENT meetings and has been awarded "Prof. Dr. Juan Carlos Arauz " First Prize for "A new technique for treating recurrent respiratory papillomatosis using chromoendoscopy associated with Endoscopic Laryngotracheal Surgery (ELS)" research paper. It was granted by the Argentine Society of Otolaryngology and Children Phonoaudiology at the IX Argentinian Congress of Pediatric Otolaryngology and Children Phonoaudiology during the III IAPO Regional Meeting, Córdoba, May 24, 2007

Introduction
Chromoendoscopy is an endoscopic technique which uses acontrast stain to paint the aerodigestive tractmucosal liningfollowed by an optical assessment to highlightingany epithelial abnormalities. Detailed and high-definition magnified views achieved with the aid of rigid endoscopes can often allow for identification of the tissue type or pathology based upon the pattern uncovered.According to the literature we reviewed, we may have been the first ones to use indigo carminein the field of otolaryngology.Tiny lesionsthat usually go overlooked with conventional microlaryngoscopy become visible upon the instillation of indigo carmine and further decreasing the chances of an early lesion postoperativerecurrence. Chromoendoscopy, in recurrent respiratory papillomatosis (RRP), helpsidentify unsuspected intraoperative lesions byclearly enhancing the view of their boundaries and surface type. It is also suitable to assess the presence of residual lesions, if any, after theirsurgical removal.

Objectives:
To demonstrate the usefulness of chromoendoscopy in RRP in laryngotracheal surgery. Material and Methods: We used indigo carmine associated with endoscopic laryngeal surgery. Before staining, the mucosa may need to be treated with a mucolytic agent to get rid of excess mucus to boost staining. Rigid suspension laryngoscopes of different proximal and distal diameters were used with chromoendoscopy. Patients underwent chromoendoscopy associated with endoscopic laryngeal surgery under general anesthesia in the O.R.

Results:
In this second phase of our research work, this diagnostic technique was applied toeighteen patients with recurrent laryngeal papillomatosis and two patients with suspected carcinoma of the larynx. We were able to optimize the intraoperative diagnosis and reduce the likelihood of the relapse risk in all patients.

Conclusion:
Chromoendoscopy associated with endoscopic laryngeal surgery is an excellent low-cost intraoperative diagnostic method for the treatment of invasive diseases of the larynx such as laryngeal papillomatosis

Keywords:
larynx, papillomatosis, chromoendoscopy, respiratory, surgery, diagnosis, intraoperative, rigid endoscope, RRP.