Autofluorescence characteristics of normal, dysplastic, and malignant squamous tissues from the oral cavity were measured with a spectrofluorometer in the excitation range of 250 - 500 nm and emission range of 350 - 750 nm. Fluorescence excitation-emission matrices (EEM) were obtained from samples collected from patients in the clinic and in the operating room. The same samples were submitted for histopathological examination following spectroscopic measurements. The contour plots obtained from the EEMs of the samples showed consistent differences between normal and abnormal tissues. All the abnormal samples showed enhanced red region (> 600 nm) fluorescence with a prominent peak at 635 nm, when excited by 410 nm light. A ratio contour plot (abnormal/normal) enhanced spectral differences in the red region. A fiber-optic based spectrofluorometer for EEM measurements is being developed for further investigations.
Vascular ectasias (dilatation) and vascular lesions of the larynx are difficult to treat with exciting modalities. Varix (enlarged vessel) of the vocal folds, vocal fold hemorrhage, vascular polyp, hemangioma, intubation or contact granuloma are common problems which disturb voice. Current applications of CO2 laser and cautery often damage the delicate vocal fold cover. The 585 nm dermatologic pulsed dye laser may be an ideal substitute. Two adult canines were examined under anesthesia via microlaryngoscopy technique. Pulsed dye laser (SPTL-1a, Candela Laser Corp., Wayland, MA) energy was delivered via the micromanipulator with the 3.1-mm spot size in single pulses of 6, 8, and 10 Joules/cm2 and applied to the vessels of the vocal folds, epiglottis, and arytenoid cartilage. Endoscopic examination was carried out immediately after the treatment and at 4 weeks postoperatively. The animals were sacrificed at 3 weeks, larynges excised, and whole organ laryngeal section were prepared for histology. Pulsed dye laser thrombosed vessels of the vocal fold using 6 or 8 Joules/cm2. Vascular break and leakage occurred at 10 Joules/cm2. Follow up examination showed excellent vessel obliteration or thrombosis without scarring or injury to the overlying tissues. Histologic examination shows vascular thrombosis without inflammation and fibrosis in the vocal fold cover. Pulsed dye laser may have promise in treatment of vascular lesions of the larynx and upper airway.
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