VISERA™ S OTV-S500 System: Expanding the Potential of Head and Neck Practice with NBI™ Technology and Stroboscopy - Olympus Professional Education On-Demand Library

Yo Kishimoto, M.D., Ph.D.

Associate Professor,
Department of Otolaryngology-Head and Neck Surgery,
Graduate School of Medicine, Kyoto University, Kyoto, Japan

Disclaimer:

NBI™ Technology is not intended to replace histopathological sampling as a means of diagnosis
The positions and statements made herein by Dr. Kishimoto are based on Dr. Kishimoto’s experiences, thoughts and opinions. As with any product, results may vary, and the techniques, instruments, and settings can vary from facility to facility. The content hereof should not be considered as a substitute for carefully reading all applicable labeling, including the Instructions for Use. Please thoroughly review the relevant user manual(s) for instructions, risks, warnings, and cautions. Techniques, instruments, and setting can vary from facility to facility. It is the clinician’s decision and responsibility in each clinical situation to decide which products, modes, medications, applications, and settings to use.
The VISERA S™ Video System Center is not designed for cardiac applications. Other combinations of equipment may cause ventricular fibrillation or seriously affect the cardiac function of the patient. Improper use of endoscopes may result in patient injury, infection, bleeding, and/or perforation. Complete indications, contraindications, warnings, and cautions are available in the Instructions for Use (IFU).
Unless otherwise noted, the visual media and clinical images contained within this material have been provided by Dr. Kishimoto. All rights reserved.

1. Importance of Endoscopic Examination in Head and Neck Practice

Endoscopic examination plays a central role in head and neck practice, with white-light imaging serving as the fundamental modality. Using white-light observation, most elevated lesions, including vocal fold polyps, can often be visually identified and clinically assessed. Recent technological advances have markedly improved image quality, enabling more detailed visualization and lesion characterization. Furthermore, the ability to digitally record endoscopic findings has become an important tool in contemporary head and neck practice.
However, the early detection of superficial laryngopharyngeal carcinoma, which has been increasing in recent years, remains challenging with white-light observation alone. In addition, evaluation of vocal fold vibration in voice disorders and assessment of tumor depth in glottic carcinoma are not possible using white-light imaging alone. These evaluations may be supported through adjunctive imaging technologies such as NBI™ (Narrow Band Imaging™) technology and stroboscopic observation, respectively. Such advanced visualization is clinically essential, as they directly contribute to appropriate treatment selection and improved therapeutic outcomes.
With conventional otolaryngologic endoscopes, NBI™ technology observation has often been limited by lower resolution compared with gastrointestinal endoscopes and by frequent halation due to surface reflection, which can complicate diagnosis. Similarly, stroboscopic observation has frequently suffered from insufficient illumination, making accurate assessment of mucosal vibration difficult, particularly in patients with strong reflectivity where close observation is challenging.
Moreover, when NBI™ technology for microvascular assessment and stroboscopy for depth evaluation are used in combination for the diagnosis of early glottic carcinoma, switching between different light sources is required, resulting in procedural complexity for both healthcare providers and patients.

2. Features of VISERA S OTV-S500

The VISERA™ S OTV-S500 light-source-integrated endoscopic system enables the use of a stroboscopic observation mode through software upgrades via a portable memory port. This system allows one-touch switching between NBI™ technology and stroboscopic observation.
Functionally, the system employs narrow-spectrum violet LEDs in addition to white LEDs, thereby supporting contrast-enhanced visualization during NBI™ technology observation. Noise reduction is achieved through frame accumulation and image processing techniques. Furthermore, increased luminous intensity enabled by high-current output, combined with the integrated light-source design, supports integrated in-system image processing. This configuration suppresses flicker caused by mismatches between the camera shutter speed and the light source flashing cycle.
Another notable feature of the system is its compact and lightweight design. The main unit measures 308 mm in width, 157 mm in height, and 461 mm in depth, with a total weight of only 10.6 kg, supporting transportation and installation across clinical environments.

3. Clinical Utility of the VISERA™ S OTV-S500 System in Early Detection and Extent Assessment of Superficial Head and Neck Cancer and High-Grade Dysplasia

Case 1: Oropharyngeal Squamous Cell Carcinoma (cT1N0M0)

Disclaimer: Representative clinical case shown for educational purposes. Individual findings and visualization may vary

White-light observation revealed an erythematous lesion with an irregular surface extending from the left soft palate to the anterior palatine arch; however, visual assessment of lesion extent was challenging. NBI™ technology observation demonstrated a well-demarcated brownish area with proliferative atypical microvessels. Using the VISERA™ S OTV-S500 system provided contrast-enhanced visualization in this case, and lesion margins appeared more clearly visualized.