Surgical Treatment of Laryngeal Papillomatosis Using NBI

Objective Multiple laryngeal papillomatosis has a high rate of recurrence after surgery. Narrowband imaging (NBI) is a novel optical enhancement technology used for the diagnosis. This is the first report to date to indicate the availability of the combination of laryngomicro surgery and videoendoscopic surgery for laryngeal papillomatosis using NBI technology. Method The patients were 34‐year‐old and 30‐year‐old men. Both cases underwent surgery in another hospital. However, because of recurrence, they were subsequently referred to our department for further evaluation. Examination in our outpatient clinic revealed papilloma‐like mucosal changes, and recurrent multiple laryngeal papillomatosis was diagnosed in both cases. Results In laryngomicroscopic surgical findings, the presence of papillomas was confirmed by NBI, and the papillomas were removed using an XPS Micro Debrider and a CO2 laser. Using the NBI system, the border between the normal mucosa and the papillomas could be clearly identified, allowing precise resection. Two months later, CO2 laser resection using a laryngeal flexible endoscope under topical anesthesia was undertaken in an outpatient setting for recurring or remaining papilloma lesions. Further treatment on the lesions has been carried out several times to date using NBI. The lesions have now been eradicated without further recurrence. Conclusion Herein we reported 2 cases of multiple laryngeal papillomatosis that were treated by tumor resection using NBI. Clearer identification of the tumor border was obtained by this technique, thus allowing minimally invasive resection. This paper demonstrates the applicability of the NBI system to the identification and resection of laryngeal papillomatosis.