Pharyngeal observation via transoral endoscopy using a lip cover‐type mouthpiece

Iwatsubo, Taro; Ishihara, Ryu; Nakagawa, Kentaro; Ohmori, Masayasu; Iwagami, Hiroyoshi; Matsuno, Kenshi; Inoue, Shuntaro; Nakahira, Hiroko; Matsuura, Noriko; Shichijo, Satoki; Maekawa, Akira; Kanesaka, Takashi; Yamamoto, Sachiko; Takeuchi, Yoji; Higashino, Koji; Uedo, Noriya; Higuchi, Kazuhide

doi:10.1111/jgh.14574

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…scope, which may cost much to repair. Iwatsubo et al reported another Valsalva maneuver method using a pediatric mouthpiece, which is cheaper than the dedicated mouthpiece used in the present study [27]. However, the unusual placement of the entire mouthpiece into the mouth may be puzzling to the patients, and it risks unintentional swallowing.…”

Section: Discussionmentioning

confidence: 71%

Usefulness of a dedicated mouthpiece for the Valsalva maneuver to visualize the hypopharynx during transoral endoscopy

et al. 2020

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Background and study aims Patients with esophageal squamous cell carcinoma (SCC) are at high risk of developing second primary SCCs in the hypopharynx. However, such second primary tumors are difficult to observe because of lumen closure. The Valsalva maneuver using a dedicated mouthpiece is a promising technique to visualize the hypopharynx during transoral endoscopy. In the current study, we investigated the utility of this method. Patients and methods The current study was a randomized, controlled, crossover trial. Patients with esophageal SCC were randomly assigned first to undergo pharyngeal observation using the dedicated mouthpiece followed by observation using a conventional mouthpiece, or vice versa. The primary endpoint was complete visualization of the hypopharynx, which was assessed blindly by three external evaluators. Results A total of 68 pharyngeal examinations were analyzed – 34 with the dedicated mouthpiece and 34 with a conventional mouthpiece. Complete visualization was achieved in 68 % of the examinations (23/34) using the dedicated mouthpiece, whereas none of the examinations using the conventional mouthpiece achieved complete visualization of the hypopharynx. Observation scores of the oropharynx were not significantly different between both types of examination (P = 0.50). No serious adverse events (AEs) occurred. Conclusions Endoscopic view of the hypopharynx was markedly improved by the Valsalva maneuver using the dedicated mouthpiece, with no serious AEs. This procedure should be included in the endoscopic examinations for the patients with esophageal SCCs.

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Section: Discussionmentioning

confidence: 71%

Usefulness of a dedicated mouthpiece for the Valsalva maneuver to visualize the hypopharynx during transoral endoscopy

et al. 2020

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“…To observe the hypopharynx, a Valsalva maneuver is performed using a specific small mouthpiece (MC Medical) that can be completely contained in the mouth. 45 This method enhances the observation of the hypopharynx, especially the post-cricoid area and posterior wall.…”

Section: Surveillance Endoscopic Modality For Metachronous Esophageal...mentioning

confidence: 97%

Surveillance for metachronous cancers after endoscopic resection of esophageal squamous cell carcinoma

Ishihara

2024

Clin Endosc

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Esophageal cancer ranks as the seventh most prevalent cancer and the sixth leading cause of cancer-related mortality globally, with 572,000 new cases and 509,000 deaths in 2018. 1 Despite a swift rise in the incidence of esophageal adenocarcinoma in Europe and North America, esophageal squamous cell carcinoma (SCC) remains the predominant histological type, constituting 80% of all esophageal cancers worldwide. 1 The literature pertaining to surveillance following treatment for esophageal squamous cell carcinoma (SCC) was reviewed and summarized, encompassing the current status and future perspectives. Analysis of the standardized mortality and incidence ratios for these cancers indicates an elevated risk of cancer in the oral cavity, pharynx, larynx, and lungs among patients with esophageal SCC compared to the general population. To enhance the efficacy of surveillance for these metachronous cancers, risk stratification is needed. Various factors, including multiple Lugol-voiding lesions, multiple foci of dilated vascular areas, young age, and high mean corpuscular volume, have been identified as predictors of metachronous SCCs. Current practice involves stratifying the risk of metachronous esophageal and head/neck SCCs based on the presence of multiple Lugol-voiding lesions. Endoscopic surveillance, scheduled 6-12 months post-endoscopic resection, has demonstrated effectiveness, with over 90% of metachronous esophageal SCCs treatable through minimally invasive modalities. Narrow-band imaging emerges as the preferred surveillance method for esophageal and head/neck SCC based on comparative studies of various imaging techniques. Innovative approaches, such as artificial intelligence-assisted detection systems and radiofrequency ablation of high-risk background mucosa, may improve outcomes in patients following endoscopic resection.

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“…A 67‐year‐old man underwent transoral endoscopy with a magnifying endoscope (EG‐L600ZW7; FUJIFILM, Tokyo, Japan) and the video endoscopic system LASEREO (FUJIFILM) for surveillance after radiation therapy for oropharyngeal cancer. Despite careful observation of the pharynx using pethidine hydrochloride 4 and the Valsalva maneuver, 5 the hypopharyngeal region was not adequately visualized (Fig. 1a).…”

Section: Brief Explanationmentioning

confidence: 99%

Endoscopic observation of the hypopharyngeal region using a super soft hood

Inoue

Ishihara

Fujii

2021

Digestive Endoscopy

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Pharyngeal observation via transoral endoscopy using a lip cover‐type mouthpiece

Cited by 6 publications

References 15 publications

Usefulness of a dedicated mouthpiece for the Valsalva maneuver to visualize the hypopharynx during transoral endoscopy

Usefulness of a dedicated mouthpiece for the Valsalva maneuver to visualize the hypopharynx during transoral endoscopy

Surveillance for metachronous cancers after endoscopic resection of esophageal squamous cell carcinoma

Endoscopic observation of the hypopharyngeal region using a super soft hood

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