{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T04:33:18Z","timestamp":1771302798938,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Stiftung Tumorforschung Kopf-Hals e.V. Wiesbaden, Germany","award":["EUR 15.000"],"award-info":[{"award-number":["EUR 15.000"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Building upon the rising value of Confocal Laser Endomicroscopy (CLE) in squamous cell carcinoma of the head and neck, we present the first application of CLE during the resection of sinonasal malignant melanomas. This study aims to evaluate the potential of CLE to assist surgeons in intraoperative decision-making, with a particular focus on resection margin assessment within the constrained nasal cavity. Methods: Two cases of sinonasal malignant melanoma were included in this study. CLE was employed to examine visible tumors and their margins, both pre- and post-endoscopic resection. The findings were compared to histopathological results as well as data on squamous cell carcinoma, for which malignancy criteria had already been established in prior projects. Results: CLE provided the real-time visualization of sinonasal malignant melanomas and their margins, successfully differentiating between healthy and neoplastic tissue compared to histopathological findings. Conclusion: CLE offers the potential for real-time assessment, aiding surgeons in more precise tumor resection and potentially improving patient outcomes. This study demonstrates the feasibility of using CLE in the resection of sinonasal malignant melanoma, highlighting its ability to differentiate between healthy and neoplastic tissue intraoperatively.<\/jats:p>","DOI":"10.3390\/jcm13154483","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T17:16:49Z","timestamp":1722446209000},"page":"4483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Confocal Laser Endomicroscopy in Resection of Sinonasal Malignant Melanoma\u2014Preliminary Report on Real-Time Margin Assessment and Support in Surgical Decision-Making"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4002-9257","authenticated-orcid":false,"given":"Nina","family":"Wenda","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Horst Schmidt Kliniken, 65199 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Fruth","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Horst Schmidt Kliniken, 65199 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Pathology, Helios HSK, 65199 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette","family":"Fisseler-Eckhoff","sequence":"additional","affiliation":[{"name":"Department of Pathology, Helios HSK, 65199 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Gosepath","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Horst Schmidt Kliniken, 65199 Wiesbaden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s11912-018-0660-7","article-title":"Contemporary Treatment Approaches to Sinonasal Mucosal Melanoma","volume":"20","author":"Amit","year":"2018","journal-title":"Curr. Oncol. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.anorl.2013.11.004","article-title":"Mucosal melanoma of the nasal cavity and paranasal sinuses","volume":"131","author":"Gilain","year":"2014","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1097\/DAD.0000000000002157","article-title":"Sinonasal Mucosal Melanoma: An Update and Review of the Literature","volume":"44","author":"Salari","year":"2022","journal-title":"Am. J. Dermatopathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1038\/s41379-022-01122-7","article-title":"Alterations in key signaling pathways in sinonasal tract melanoma. A molecular genetics and immunohistochemical study of 90 cases and comprehensive review of the literature","volume":"35","author":"Lasota","year":"2022","journal-title":"Mod. Pathol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/MOO.0000000000000428","article-title":"Updates in the management of sinonasal mucosal melanoma","volume":"26","author":"Crippen","year":"2018","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Chatelet, F., Simon, F., Bedarida, V., Le Clerc, N., Adle-Biassette, H., Manivet, P., Herman, P., and Verillaud, B. (2021). Surgical Management of Sinonasal Cancers: A Comprehensive Review. Cancers, 13.","DOI":"10.3390\/cancers13163995"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5770","DOI":"10.3748\/wjg.15.5770","article-title":"Confocal laser endomicroscopy in the \u201cin vivo\u201d histological diagnosis of the gastrointestinal tract","volume":"15","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Frieling, T., Gjini, B., Melchior, I., Hemmerlein, B., Kiesslich, R., and Kuhlbusch-Zicklam, R. (Z. F\u00fcr Gastroenterol., 2023). Eosinophilic esophagitis and duodenal food challenge\u2014Evaluation through endoscopic confocal laser endomicroscopy, Z. F\u00fcr Gastroenterol., Epub ahead of print.","DOI":"10.1055\/a-2057-9125"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"220185","DOI":"10.1183\/16000617.0185-2022","article-title":"The role of confocal laser endomicroscopy in pulmonary medicine","volume":"32","author":"Tian","year":"2023","journal-title":"Eur. Respir. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Bitaraf, M., Ghafoori Yazdi, M., and Amini, E. (2023). Upper Tract Urothelial Carcinoma (UTUC) Diagnosis and Risk Stratification: A Comprehensive Review. Cancers, 15.","DOI":"10.3390\/cancers15204987"},{"key":"ref_11","first-page":"3","article-title":"Intraoperative confocal laser endomicroscopy for brain tumors\u2014Potential and challenges from a neuropathological perspective","volume":"3","author":"Maragkou","year":"2022","journal-title":"Free Neuropathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4433","DOI":"10.1007\/s00405-021-06659-y","article-title":"Intraoperative free margins assessment of oropharyngeal squamous cell carcinoma with confocal laser endomicroscopy: A pilot study","volume":"278","author":"Sievert","year":"2021","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1001\/archoto.2012.213","article-title":"Systematic intraoperative application of confocal endomicroscopy for early detection and resection of squamous cell carcinoma of the head and neck: A preliminary report","volume":"138","author":"Pogorzelski","year":"2012","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_14","first-page":"e396","article-title":"Technical Note: First Use of Endonasal Confocal Laser Endomicroscopy\u2014Feasibility and Proof of Concept","volume":"26","author":"Wenda","year":"2021","journal-title":"Int. Arch. Oto-Rhino-Laryngol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Wenda, N., Fruth, K., Fisseler-Eckhoff, A., and Gosepath, J. (2023). The Multifaceted Role of Confocal Laser Endomicroscopy in Head and Neck Surgery: Oncologic and Functional Insights. Diagnostics, 13.","DOI":"10.3390\/diagnostics13193081"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/00005537-199902000-00007","article-title":"Management options and survival in malignant melanoma of the sinonasal mucosa","volume":"109","author":"Lund","year":"1999","journal-title":"Laryngoscope"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/00016489.2019.1635269","article-title":"Impact of adjuvant therapy on survival for sinonasal mucosal melanoma","volume":"140","author":"Lai","year":"2020","journal-title":"Acta Oto-laryngol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/CMR.0000000000000516","article-title":"Prognosis of endoscopic surgery and traditional open resection in mucosal melanoma of the nasal cavity and paranasal sinus","volume":"29","author":"Yin","year":"2019","journal-title":"Melanoma Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1016\/j.cgh.2007.07.013","article-title":"Functional imaging of colonic mucosa with a fibered confocal microscope for real-time in vivo pathology","volume":"5","author":"Wang","year":"2007","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/00004397-198902930-00011","article-title":"Complications of intravenous fluorescein injections","volume":"29","author":"Lipson","year":"1989","journal-title":"Int. Ophthalmol. Clin."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1007\/s00784-021-04156-4","article-title":"Diagnostic accuracy of in vivo early tumor imaging from probe-based confocal laser endomicroscopy versus histologic examination in head and neck squamous cell carcinoma","volume":"26","author":"Abbaci","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sethi, S., Ju, X., Logan, R.M., Sambrook, P., McLaughlin, R.A., and Jamieson, L.M. (2021). Diagnostic Accuracy of Confocal Laser Endomicroscopy for the Diagnosis of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182312390"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Frenken, A.K., Sievert, M., Panuganti, B., Aubreville, M., Meyer, T., Scherzad, A., Gehrke, T., Scheich, M., Hackenberg, S., and Goncalves, M. (Laryngoscope, 2024). Feasibility of Optical Biopsy During Endoscopic Sinus Surgery with Confocal Laser Endomicroscopy: A Pilot Study, Laryngoscope, Epub ahead of print.","DOI":"10.1002\/lary.31503"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"26","DOI":"10.14639\/0392-100X-N1643","article-title":"Systematic interpretation of confocal laser endomicroscopy: Larynx and pharynx confocal imaging score","volume":"42","author":"Sievert","year":"2022","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"105978","DOI":"10.1016\/j.oraloncology.2022.105978","article-title":"Systematic classification of confocal laser endomicroscopy for the diagnosis of oral cavity carcinoma","volume":"132","author":"Sievert","year":"2022","journal-title":"Oral Oncol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/15\/4483\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:27:15Z","timestamp":1760110035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/15\/4483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":25,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["jcm13154483"],"URL":"https:\/\/doi.org\/10.3390\/jcm13154483","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,31]]}}}