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In vivo nerve identification in head and neck surgery using diffuse reflectance spectroscopy

Journal Article (2018)
Author(s)

Gerrit C. Langhout (Nederlands Kanker Instituut - Antoni van Leeuwenhoek ziekenhuis)

Koert F.D. Kuhlmann (Nederlands Kanker Instituut - Antoni van Leeuwenhoek ziekenhuis)

Pim Schreuder (Nederlands Kanker Instituut - Antoni van Leeuwenhoek ziekenhuis)

Torre Bydlon (Philips Research)

Ludi E. Smeele (Nederlands Kanker Instituut - Antoni van Leeuwenhoek ziekenhuis, Universiteit van Amsterdam)

Michiel W.M. van den Brekel (Nederlands Kanker Instituut - Antoni van Leeuwenhoek ziekenhuis)

Henricus J.C.M. Sterenborg (Nederlands Kanker Instituut - Antoni van Leeuwenhoek ziekenhuis, Amsterdam UMC)

Benno H.W. Hendriks (Philips Research, TU Delft - Medical Instruments & Bio-Inspired Technology)

Theo J.M. Ruers (Nederlands Kanker Instituut - Antoni van Leeuwenhoek ziekenhuis, University of Twente)

Research Group
Medical Instruments & Bio-Inspired Technology
DOI related publication
https://doi.org/10.1002/lio2.174
More Info
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Publication Year
2018
Language
English
Research Group
Medical Instruments & Bio-Inspired Technology
Issue number
5
Volume number
3
Pages (from-to)
349-355
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Abstract

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.