For endoscopic examinations in the outpatient clinic, the fiber-optic laryngoscope (FOL) is often used as a standard, with an estimated thousand laryngoscopies performed daily worldwide. The tremendous progress in medical imaging technology led to the development of digital chip-on-tip endoscopy. The high-definition laryngoscope (HDL) and narrow band imaging (NBI) were developed. In NBI, the white light is filtered in such a way that only the blue and green wavelengths remain, which are absorbed by hemoglobin. Changes in blood vessels, associated with the development of malignant lesions, can be better visualized in the examined mucosa.
This dissertation of Constanze Scholman demonstrated the positive effects of advancements in medical imaging technology from FOL to HDL and HDL-NBI. HDL and HDL-NBI have improved accuracy and precision in detecting pharyngeal and laryngeal lesions. During follow-up, there was no difference in detecting local recurrences with HDL or HDL-NBI. Most newly developed diagnostic tools undergo a so-called technology adoption life cycle. Our studies provide statistical evidence of the improved performance of the new technologies compared to the standard technology. Our research also highlights the influence of clinical experience for a more accurate and precise diagnosis. In daily clinical practice, medical professionals can now make a well-informed choice about the type of flexible endoscopy to use for a reliable diagnosis, taking into account their own clinical experience and that of their colleagues. Additionally, we can conclude that flexible laryngoscopic biopsy in the outpatient clinic can replace endoscopic evaluation under anesthesia as the standard procedure.
