Real-time subglottic stenosis imaging using optical coherence tomography in the rabbit

Area of Science:

• Medical Imaging
• Otolaryngology
• Neonatal Care

Background:

• Subglottic stenosis (SGS) is a severe airway complication of endotracheal intubation, particularly dangerous in neonates due to their small airways.
• Early detection and monitoring are crucial for preventing the progression of airway trauma to irreversible SGS.

Purpose of the Study:

• To evaluate the efficacy of optical coherence tomography (OCT) in detecting airway injury and scar formation.
• To assess OCT's potential as a noninvasive bedside tool for monitoring intubated neonates and preventing SGS.

Main Methods:

• A rabbit model was used to induce and study subglottic stenosis (SGS) via epithelial injury.
• A high-speed, high-resolution OCT system with a fiber-optic probe was employed to image the subglottic airway.
• OCT images were compared with conventional endoscopy and histology at multiple time points.

Main Results:

• The rabbit model successfully and reproducibly induced Grade I SGS.
• OCT accurately identified airway structures, delineated tissue planes (epithelium, lamina propria, cartilage), and detected trauma-induced changes.
• OCT imaging correlated well with endoscopic and histologic findings, demonstrating its capability to visualize airway injury.

Conclusions:

• Optical coherence tomography (OCT) effectively identifies subglottic scarring and tissue changes in the airway, with imaging depth up to 1 mm.
• This technology represents a significant advancement towards minimally invasive monitoring of intubated neonates, aiming to prevent SGS.