Development of a new method using narrow band imaging for taste assessment.

OBJECTIVES/HYPOTHESIS: The observation of fungiform papillae is a useful objective taste examination. The purpose of this study is to develop a new method using narrow band imaging for assessment of taste function. STUDY DESIGN: Using a narrow band imaging endoscope, we assessed the number and blood vessel morphology of fungiform papillae and compared with the gustatory threshold by the filter paper disc test. METHODS: The number of fungiform papillae was counted in 20 mm(2) , and blood vessels in fungiform papillae were evaluated morphologically by a five-point scoring system in 11 patients who had undergone middle ear surgery. The filter taste disc test was performed simultaneously to obtain the gustatory threshold and was compared with the number and blood vessel morphology of fungiform papillae. RESULTS: Using a narrow band imaging endoscope, we could clearly detect not only fungiform papillae but also blood vessel morphology. There was a significant correlation between the values of the number of papillae and blood vessel morphology. Moreover, these two parameters revealed a significant inverse correlation with gustatory function. As expected, both parameters on the affected side were significant lower than those on the unaffected side in patients. CONCLUSIONS: The assessment of fungiform papillae using narrow band imaging endoscopy is easy, highly sensitive, and reliable; therefore, it might be useful as an objective examination of taste function. LEVEL OF EVIDENCE: N/A.

A new and less invasive procedure for arytenoid adduction surgery: endoscopic-assisted arytenoid adduction surgery.

OBJECTIVES/HYPOTHESIS: Arytenoid adduction (AA) is the most effective procedure for improving voice function in patients affected by unilateral vocal fold paralysis (UVFP), but it is often associated with severe complications following airway obstruction. The aim of this study is to describe a new and less invasive AA surgical procedure termed endoscopic-assisted AA surgery (EAAS) and to evaluate its voice outcomes. STUDY DESIGN: We demonstrated this method using extirpated larynges from three laryngeal cancer patients. Ten patients with severe UVFP underwent EAAS alone or combined with type I thyroplasty or lipoinjection laryngoplasty. METHODS: EAAS involves the placement of permanent adducting sutures around the muscular process (MP) of the arytenoid cartilage using two needles, a penetration needle and a loop needle, under endoscopic guidance. To define the anatomic position of the MP for safer needle insertion, the location of the MP was measured relative to three landmarks on computed tomography/X-ray images of the larynges and in resected larynges. For all patients with UVFP, the maximum phonation time, mean airflow rate, and three acoustic analysis parameters were measured before and after EAAS. RESULTS: The values of the three variables were similar in all cases. Most patients achieved a maximum phonation time of more than 10 seconds and a mean airflow rate of less than 200 mL/second. All three acoustic analysis parameters were significantly improved after surgery. CONCLUSIONS: EAAS is a simple and effective arytenoid rotation procedure.