Open AccessIn vivo nerve identification in head and neck surgery using diffuse reflectance spectroscopy
Author(s) -
Langhout Gerrit C.,
Kuhlmann Koert F.D.,
Schreuder Pim,
Bydlon Torre,
Smeele Ludi E.,
Brekel Michiel W.M.,
Sterenborg Henricus J.C.M.,
Hendriks Benno H.W.,
Ruers Theo J.M.
Publication year - 2018
Publication title -
laryngoscope investigative otolaryngology
Language(s) - English
Resource type - Journals
ISSN - 2378-8038
DOI - 10.1002/lio2.174
Subject(s) - medicine , head and neck , electromyography , in vivo , diffuse reflectance infrared fourier transform , adipose tissue , anatomy , biomedical engineering , pathology , surgery , chemistry , biology , physical medicine and rehabilitation , microbiology and biotechnology , biochemistry , photocatalysis , catalysis
Background Careful identification of nerves during head and neck surgery is essential to prevent nerve damage. Currently, nerves are identified based on anatomy and appearance, optionally combined with electromyography (EMG). In challenging cases, nerve damage is reported in up to 50%. Recently, optical techniques, like diffuse reflectance spectroscopy (DRS) and fluorescence spectroscopy (FS) show potential to improve nerve identification. Methods 212 intra‐operative DRS/FS measurements were performed. Small nerve branches (1–3 mm), on near‐nerve adipose tissue, muscle and subcutaneous fat were measured during 11 surgical procedures. Tissue identification was based on quantified concentrations of optical absorbers and scattering parameters. Results Clinically comprehensive parameters showed significant differences (<0.05) between the tissues. Classification using k‐Nearest Neighbor resulted in 100% sensitivity and a specificity of 83% (accuracy 91%), for the identification of nerve against surrounding tissues. Conclusions DRS/FS is a potentially useful intraoperative tool for identification of nerves from adjacent tissues. Level of Evidence Observational proof of principle study.