Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan;132(1):36-44.
doi: 10.1002/lary.29891. Epub 2021 Oct 11.

A Scoping Review of Ongoing Fluorescence-Guided Surgery Clinical Trials in Otolaryngology

Kayva L Crawford  1 , Fernanda V Pacheco  1 , Yu-Jin Lee  2 , Marisa Hom  2 , Eben L Rosenthal  2 , Quyen T Nguyen  1 , Ryan K Orosco  1   3
Affiliations

A Scoping Review of Ongoing Fluorescence-Guided Surgery Clinical Trials in Otolaryngology

Kayva L Crawford et al. Laryngoscope. 2022 Jan.

Abstract

Objective: Fluorescence-guided surgery (FGS) is a rapidly developing intraoperative technology, and many contrast agents are currently under investigation. We sought to provide a review of the current state of FGS clinical trials in Otolaryngology, emphasizing its oncologic applications.

Methods: According to the preferred reporting Items for systematic reviews and meta-analyses (PRISMA) workflow for scoping reviews, a clinical trial search was performed across multiple international clinical trials registries, searching for permutations of "fluorescence," "tumor," "surgery," and "nerve" to identify all relevant studies. Studies that were active, enrolling, or soon to be enrolling patients undergoing head and neck surgery were included.

Results: Nineteen studies were eligible for inclusion. Seventeen studies are focused on FGS for oncologic resection and lymph node detection. One study assesses peripheral nerve fluorescence, and one evaluates normal parathyroid function after thyroidectomy. Contrast agents under development are conjugated to fluorophores that excite in the 800 nm (indocyanine green), 410 nm (5-aminolevulinic acid), 700 nm (Cyanine 5.5), and 525 nm ranges (fluorescein derivatives).

Conclusion: Presently, there are 19 ongoing trials investigating novel FGS contrast agents for their safety, efficacy, and utility in Otolaryngology-Head and Neck Surgery. These agents rely on unique fluorophores and absorption ranges in the near-infrared and visible light spectra. FGS studies are expanding within Otolaryngology-Head and Neck Surgery with profound implications in oncologic surgery, lymph node detection, and anatomic and functional assessment. Laryngoscope, 132:36-44, 2022.

Keywords: Clinical trials; fluorescence-guided surgery; head and neck; intraoperative imaging.

PubMed Disclaimer

References

BIBLIOGRAPHY

    1. Keereweer S, Sterenborg HJ, Kerrebijn JD, Van Driel PB, Baatenburg de Jong RJ, Lowik CW. Image-guided surgery in head and neck cancer: current practice and future directions of optical imaging. Head Neck 2012;34:120-126.
    1. van Keulen S, Nishio N, Fakurnejad S, et al. The clinical application of fluorescence-guided surgery in head and neck cancer. J Nucl Med 2019;60:758-763.
    1. Bernier J, Cooper JS, Pajak TF, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (#9501). Head Neck 2005;27:843-850.
    1. Lee YJ, Krishnan G, Nishio N, et al. Intraoperative fluorescence-guided surgery in head and neck squamous cell carcinoma. Laryngoscope 2020;131:529-534.
    1. Eldeeb H, Macmillan C, Elwell C, Hammod A. The effect of the surgical margins on the outcome of patients with head and neck squamous cell carcinoma: single institution experience. Cancer Biol Med 2012;9:29-33.

Publication types

Substances

LinkOut - more resources