Real time in-vivo miniature endoscopic surveillance system for imaging of nasopharynx

OBJECTIVE: To test the feasibility of a real time miniature endoscope system for imaging the nasopharynx. STUDY DESIGN: Preclinical assessment on skull model and cadaver. METHODS: A 3.5 mm miniature endoscope was fabricated and the image capture of the nasopharynx was investigated by positioning the miniature camera system at the posterior free edge of the vomer bone. Wireless real time transmission of the images and quality was tested in a skull model. Next, three nasopharyngeal surveillance miniature camera system were developed for possible clinical translation. Two prototypes were anchored on the nasal septum and the last prototype was designed using a patient self-administered surveillance process. These prototypes were tested for feasibility on both the phantom skull and cadaveric model. Risk assessments were also performed to assess risk, safety and validate the reliability of the material utilized for clinical translation. RESULTS: Insertion and anchorage of the miniature surveillance endoscope prototypes at the vomer bone were feasible on all 3 prototypes. The quality of captured images was reasonable and miniaturized camera was responsive to pan at different angles so that the entire nasopharynx may be surveyed. Risk assessments on the material such as pull out test, breaking force analysis, finite element test and tensile strength test were reliable for possible clinical translation. CONCLUSIONS: Real time miniature endoscope system for surveillance of nasopharyngeal cancer is feasible. Clinical translation of this technology was possible but requires further refinement in enhancing image quality and wireless transmission of the captured images.