SPIES optical biopsies in laryngeal papillomatosis. The 4 waves sign

Abstract

Laryngeal papillomatosis represents a challenging disease for the ENT surgeon. It has a recurrent pattern, with lesions that tend to be more and more extensive and affect the quality of life of the patient. Due to it’s viral etiology, multiple medical therapies have been attempted for these patients. Their results are still somewhat controversial, taking into account the local and systemic side effects. Diabetes mellitus (DM) patients are considered to be relatively immunocompromised and the laryngeal papillomatosis is more severe. The lesions occur at an epithelial level. The earlier the diagnosis, the better the outcome of the patient. The advancements made in the field of medical technologies made possible ample surgical interventions that maintain the natural airway. Out of these, the most used today is the CO2 LASER, with good results when correctly managed. The purpose of this paper is to present the use of an endoscopic method of examination, that uses SPIES filters, for a more accurate diagnosis of the epithelial lesions, which allows a better evaluation and more thorough follow-up of our patients. We believe attention should be paid to this topic due to the surgical, epidemiological and biological reasons.