In vivo nerve identification in head and neck surgery using diffuse reflectance spectroscopy

Gerrit C. Langhout (Corresponding Author), Koert F.D. Kuhlmann, Pim Schreuder, Torre Bydlon, Ludi E. Smeele, Michiel W.M. van den Brekel, Henricus J.C.M. Sterenborg, Benno H.W. Hendriks, Theo J.M. Ruers

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
136 Downloads (Pure)


Background: Careful identification of nerves during head and neck surgery is essential to prevent nerve damage. Currently, nerves are identified based on anatomy and appearance, optionally combined with electromyography (EMG). In challenging cases, nerve damage is reported in up to 50%. Recently, optical techniques, like diffuse reflectance spectroscopy (DRS) and fluorescence spectroscopy (FS) show potential to improve nerve identification. Methods: 212 intra-operative DRS/FS measurements were performed. Small nerve branches (1-3 mm), on near-nerve adipose tissue, muscle and subcutaneous fat were measured during 11 surgical procedures. Tissue identification was based on quantified concentrations of optical absorbers and scattering parameters. Results: Clinically comprehensive parameters showed significant differences (<0.05) between the tissues. Classification using k-Nearest Neighbor resulted in 100% sensitivity and a specificity of 83% (accuracy 91%), for the identification of nerve against surrounding tissues. Conclusions: DRS/FS is a potentially useful intraoperative tool for identification of nerves from adjacent tissues. Level of Evidence: Observational proof of principle study.

Original languageEnglish
Pages (from-to)349-355
Number of pages7
JournalLaryngoscope Investigative Otolaryngology
Issue number5
Early online date9 Aug 2018
Publication statusPublished - 1 Oct 2018


  • diffuse reflectance spectroscopy
  • DRS
  • Head and heck
  • peripheral nerves
  • surgery


Dive into the research topics of 'In vivo nerve identification in head and neck surgery using diffuse reflectance spectroscopy'. Together they form a unique fingerprint.

Cite this