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Peer-reviewedCC BY 4.0DEN Open

Improved Visualization of the Internal Branch of the Superior Laryngeal Nerve during Pharyngeal Endoscopic Subepithelial Dissection with Use of Red Dichromatic Imaging

  • Yukihisa Fujinaga1
  • Yoshiki Tamada1
  • Yohei Yamaguchi1
  • Kyohei Matsuura1
  • Hiroki Kachi1
  • Masafumi Oyama1
  • Hitoshi Mori1
  • Satoshi Iwai1
  • Akira Mitoro2
  • Hitoshi Yoshiji1
  1. 1Department of Gastroenterology Nara Medical University Nara Japan
  2. 2Division of Endoscopy Nara Medical University Nara Japan
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Abstract

Endoscopic subepithelial dissection is a minimally invasive treatment for superficial pharyngeal neoplastic lesions, requiring preservation of important neural structures such as the internal branch of the superior laryngeal nerve (ibSLN). We report a case in which red dichromatic imaging (RDI) appeared to improve the visualization of a linear structure presumed to be the ibSLN compared with white‐light imaging (WLI). A 57‐year‐old woman underwent endoscopic subepithelial dissection for a 5‐mm superficial lesion on the pharyngoepiglottic fold. Both WLI and RDI revealed a whitish linear structure beneath the lesion, which was presumed to represent the ibSLN based on its anatomical location and course. The presumed nerve structure appeared to be more clearly delineated with RDI than with WLI before mucosal incision and remained identifiable after submucosal injection and during dissection. This enhanced visualization may have helped guide the selection of the mucosal incision line and dissection plane. En bloc resection was achieved without apparent nerve injury. No dysphagia, hoarseness, or other adverse events occurred postoperatively. These findings suggest that RDI may serve as a useful adjunct for visualization of the structure presumed to represent the ibSLN during pharyngeal endoscopic subepithelial dissection and may support nerve‐preserving strategies.

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Cite

BibTeXRIS
BibTeX
@article{fujinaga2026improved,
  title = {{Improved Visualization of the Internal Branch of the Superior Laryngeal Nerve during Pharyngeal Endoscopic Subepithelial Dissection with Use of Red Dichromatic Imaging}},
  author = {Yukihisa Fujinaga and Yoshiki Tamada and Yohei Yamaguchi and Kyohei Matsuura and Hiroki Kachi and Masafumi Oyama and Hitoshi Mori and Satoshi Iwai and Akira Mitoro and Hitoshi Yoshiji},
  journal = {DEN Open},
  year = {2026},
  month = nov,
  doi = {10.1002/deo2.70460},
  url = {https://doi.org/10.1002/deo2.70460},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Improved Visualization of the Internal Branch of the Superior Laryngeal Nerve during Pharyngeal Endoscopic Subepithelial Dissection with Use of Red Dichromatic Imaging
AU  - Yukihisa Fujinaga
AU  - Yoshiki Tamada
AU  - Yohei Yamaguchi
AU  - Kyohei Matsuura
AU  - Hiroki Kachi
AU  - Masafumi Oyama
AU  - Hitoshi Mori
AU  - Satoshi Iwai
AU  - Akira Mitoro
AU  - Hitoshi Yoshiji
PY  - 2026
DA  - 2026/11/04
JO  - DEN Open
DO  - 10.1002/deo2.70460
UR  - https://doi.org/10.1002/deo2.70460
AB  - Endoscopic subepithelial dissection is a minimally invasive treatment for superficial pharyngeal neoplastic lesions, requiring preservation of important neural structures such as the internal branch of the superior laryngeal nerve (ibSLN). We report a case in which red dichromatic imaging (RDI) appeared to improve the visualization of a linear structure presumed to be the ibSLN compared with white‐light imaging (WLI). A 57‐year‐old woman underwent endoscopic subepithelial dissection for a 5‐mm superficial lesion on the pharyngoepiglottic fold. Both WLI and RDI revealed a whitish linear structure beneath the lesion, which was presumed to represent the ibSLN based on its anatomical location and course. The presumed nerve structure appeared to be more clearly delineated with RDI than with WLI before mucosal incision and remained identifiable after submucosal injection and during dissection. This enhanced visualization may have helped guide the selection of the mucosal incision line and dissection plane. En bloc resection was achieved without apparent nerve injury. No dysphagia, hoarseness, or other adverse events occurred postoperatively. These findings suggest that RDI may serve as a useful adjunct for visualization of the structure presumed to represent the ibSLN during pharyngeal endoscopic subepithelial dissection and may support nerve‐preserving strategies.
SN  - 2692-4609
ER  -