Hostname: page-component-f7d5f74f5-wqfsk Total loading time: 0 Render date: 2023-10-03T03:36:00.375Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "coreDisableSocialShare": false, "coreDisableEcommerceForArticlePurchase": false, "coreDisableEcommerceForBookPurchase": false, "coreDisableEcommerceForElementPurchase": false, "coreUseNewShare": true, "useRatesEcommerce": true } hasContentIssue false

Comparison of contact endoscopy and frozen section histopathology in the intra-operative diagnosis of laryngeal pathology

Published online by Cambridge University Press:  15 August 2007

D Cikojević
Department of ENT, Split University Hospital, Croatia
I Glunčić*
Department of ENT, Split University Hospital, Croatia
V Pešutić-Pisac
Department of Pathology, Split University Hospital, Croatia
Address for correspondence: Prof Ivo Glunčić, ENT Department, Split University Hospital, Spinčićeva 1, HR-21000 Split, Croatia. Fax: +385 21 556 044 E-mail:


Andrea et al. were the first to use contact endoscopy in the diagnosis of laryngeal disease, in 1995. This method enables in vivo microscopy of laryngeal mucosa.

In the present study, comparison of contact endoscopy with frozen section histopathology was performed in 142 patients with various diseases of the larynx. Paraffin section histopathology diagnosed 70 benign lesions, 23 precancerous lesions and 49 malignant lesions. Frozen section histopathology showed a sensitivity of 89.8 per cent, a specificity of 98.9 per cent and an accuracy of 95.7 per cent (χ2 = 1.5; p = 0.18). Frozen histopathology diagnosed 45 malignant lesions, including one false positive and five false negative results. Contact endoscopy yielded a sensitivity of 79.59 per cent, a specificity of 100 per cent and an accuracy of 92.95 per cent (χ2 = 8.1; p = 0.002). All malignant lesions diagnosed by contact endoscopy were confirmed by histopathology; contact endoscopy failed to recognise malignant lesions in 10 patients.

Contact endoscopy is preferable to frozen section histopathology as it is noninvasive, provides information on microscopic diagnosis and laryngeal lesion margins, and enables visualisation of the laryngeal mucosa microvasculature. The use of contact endoscopy along with frozen section histopathology improves diagnostic accuracy and allows for operative (or other) therapy to continue according to the results obtained.

Main Article
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


1Silberberg, S. Principles and Practice of Surgical Pathology, 2nd edn.New York: Churchill Livingstone, 1990;112Google Scholar
2Byers, R, Bland, K, Borlase, B, Luna, M. The prognostic and therapeutic value of frozen section determinations in the surgical treatment of squamous carcinoma of the head and neck. Am J Surg 1978;136:525–31CrossRefGoogle ScholarPubMed
3Looser, K, Shah, P, Strong, E. The significance of “positive” margins in surgically resected epidermoid carcinoma. Head Neck Surg 1978;1:107–11CrossRefGoogle Scholar
4Andrea, M, Dias, O, Santos, A. Contact endoscopy during microlaryngeal surgery. A new technique for endoscopic examination of the larynx. Ann Otol Rhinol Laryngol 1995;104:333–9CrossRefGoogle ScholarPubMed
5Andrea, M, Dias, O, Santos, A. Contact endoscopy of the vocal cord. Normal and pathological patterns. Acta Otolaryngol (Stockh) 1995;115:314–16CrossRefGoogle ScholarPubMed
6Andrea, M, Dias, O. Atlas of Rigid and Contact Endoscopy in Microlaryngeal Surgery. Philadelphia: Lippincott-Raven, 1995Google Scholar
7Cikojević, D. Contact Endoscopy in the Intraoperative Diagnosis of Laryngeal Pathology. Doctoral Dissertation [in Croatian]. Zagreb: School of Medicine, University of Zagreb, 2005;60–3Google Scholar
8Wardrop, PJ, Sim, S, McLaren, K. Contact endoscopy of the larynx: a quantitative study. J Laryngol Otol 2000;114:437–40CrossRefGoogle ScholarPubMed
9Carriero, E, Galli, J, Fadda, G, Di Girolamo, S, Ottaviani, F, Paludetti, G. Preliminary experiences with contact endoscopy of the larynx. Eur Arch Otorhinolaryngol 2000;257:6871CrossRefGoogle ScholarPubMed
10Andrea, M, Dias, O, Macor, C, Santos, A, Varandas, J. Contact endoscopy of the nasal mucosa. Acta Otolaryngol 1997;117:307–11CrossRefGoogle ScholarPubMed
11L'Estrange, P, Benvenius, J, Williams, L. Intraoral application of microcolpohysteroscopy. A new technique for clinical examination of oral tissues at high magnification. Oral Surg Oral Med Oral Pathol 1989;67:282–5CrossRefGoogle ScholarPubMed
12Huang, X, Mai, H, Deng, M, Shao, J, Su, Y, Lin, K et al. . Examination of nasopharyngeal epithelium with contact endoscopy. Acta Otolaryngol 2001;121:98102Google Scholar
13Pak, M, To, K, Leung, S. In vivo diagnosis of persistent and recurrent nasopharyngeal carcinoma by contact endoscopy. Laryngoscope 2002;112:1459–66CrossRefGoogle ScholarPubMed
14Atsushi, N, Masanori, U, Keijiro, F, Tomonori, T, Masafumi, S. Observation of tongue papillae by video microscopy and contact endoscopy to investigate their correlation with taste function. Auris Nasus Larynx 2004;31:255–9Google Scholar
15Cikojević, D, Glunčić, I, Pešutić-Pisac, V. Contact endoscopy in the diagnosis of laryngeal tumors. (abstract) In: Abstract of the International Otolaryngologic Congres. 10th Danube Symposium, Dubrovnik, Croatia, 2002:56Google Scholar
16Arens, C, Dreyer, T, Glanz, H, Malzahn, K. Compact endoscopy of the larynx. Ann Otol Rhinol Laryngol 2003;112:113–19CrossRefGoogle ScholarPubMed