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The choice of chromogen and reliability of contact rhinoscopy in the irradiated nasopharynx

Published online by Cambridge University Press:  04 January 2007

Martin W Pak ,
Samuel Chow  and
C A van Hasselt
Martin W Pak*
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, SARChina
Samuel Chow
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, SARChina
C A van Hasselt
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, SARChina
*
Address for correspondence: Professor Charles Andrew van Hasselt, Division of Otorhinolaryngology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, 30–32 Ngan Shing Street, Shatin, New Territories, Hong Kong, SAR, China. Fax: (852) 2646 6312 E-mail: andrewvan@cuhk.edu.hk
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Abstract

A cross-sectional randomised single blind study was conducted to assess how concentrations of chromogen (vital stain) and the characteristics of the assessors affect the assessment of contact rhinoscopy. Twenty-eight patients who had undergone external radiotherapy for nasopharyngeal carcinoma were assessed by contact rhinoscopy using 0.5 per cent and 1 per cent methylene blue stain on opposite sides of the nasopharynx. Three independent observers assessed the visual clarity of the 45 contact endoscopic images showing squamous metaplasia according to a visual analogue scale. The intraclass correlation coefficients were 0.916 to 0.957 and 0.839 to 0.964 for intra-observer reliability of assessors in the groups of 0.5 per cent and 1 per cent stains, respectively. The intraclass correlation coefficients for inter-observer reliability of assessors were 0.884 and 0.885 in the groups of 0.5 per cent and 1 per cent stains, respectively. The mean scores of clarity of the cellular details were statistically higher in the group of 1 per cent stain among all assessors. These results showed that the assessment of squamous metaplasia by contact endoscopy is highly reliable irrespective of the clinical experience and knowledge of histopathology of the assessors. One per cent methylene blue should be the vital stain of choice in contact endoscopy.

Keywords

EndoscopyStain, ReliabilityMetaplasiaNasopharyngeal Carcinoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 2 , February 2008 , pp. 177 - 180
Copyright
Copyright © JLO (1984) Limited 2006

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