Feasibility of confocal laser endomicroscopy as an optical biopsy method for SCC on the auricle : an exploratory study

Müller-Diesing F, Sievert M, Panuganti BA, Aubreville M, Porsche N, Hackenberg S, Stöth M, Scherzad A, Meyer J, Wirth M, Goncalves M (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Oral and maxillofacial surgery Springer Verlag

Book Volume: 30

Article Number: 21

Journal Issue: 1

DOI: 10.1007/s10006-026-01506-y

Abstract

Purpose: In the resection of cutaneous squamous cell carcinomas (cSCC) of the auricle, the challenge lies in ensuring a safe excision with adequate surgical margins in an aesthetically and functionally sensitive area, while keeping the resulting defect as small as possible. To contribute to achieving this goal, the present study is the first to investigate the potential of confocal laser endomicroscopy (CLE) as a method of optical biopsy for cSCC. Methods: A total of 82 CLE sequences (from 7 patients) showing cSCC or healthy tissue were blinded and presented to four different investigators for evaluation; in addition, presence of individual malignancy criteria derived from the literature were assessed. Results: The distinction between healthy tissue and cSCC was achieved reliably. On average, the investigators reached a sensitivity of 96.95% and a specificity of 89.65%. A substantial interrater agreement was observed (Fleiss’ kappa 0.74). The malignancy criteria proved valid in this region, as all were significantly more frequent in sequences showing SCC (p < 0.001). The most sensitive single criterion was the “presence of large round cells with nuclear atypia”. Conclusion: The present study demonstrates the first feasibility of CLE as a tool for distinguishing between healthy tissue and tumor when defining tumor margins of cSCC on the auricle. Further studies are necessary to establish its clinical utility, including investigations into the application of evaluation scoring systems.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik)

Involved external institutions

Universitätsklinikum Aachen (UKA) DE Germany (DE) Washington University in St. Louis US United States (USA) (US) Fachhochschule Flensburg DE Germany (DE) Universitätsklinikum Würzburg DE Germany (DE)

How to cite

APA:

Müller-Diesing, F., Sievert, M., Panuganti, B.A., Aubreville, M., Porsche, N., Hackenberg, S.,... Goncalves, M. (2026). Feasibility of confocal laser endomicroscopy as an optical biopsy method for SCC on the auricle : an exploratory study. Oral and maxillofacial surgery, 30(1). https://doi.org/10.1007/s10006-026-01506-y

MLA:

Müller-Diesing, Flurin, et al. "Feasibility of confocal laser endomicroscopy as an optical biopsy method for SCC on the auricle : an exploratory study." Oral and maxillofacial surgery 30.1 (2026).

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