Abstract
Background
Metachronous cancer rate in the pharynx is high before and after the treatment of esophageal cancer. Endoscopic observation is difficult in the pharynx especially in the postcricoid area. Pharyngeal cancer in the postcricoid area has been often found in advanced stage. Valsalva maneuver has been reported to improve the visibility.
Methods
From May 2017 we introduced a dedicated mouthpiece to conduct Valsalva maneuver. One hundred consecutive patients who had been observed throughout the pharynx by one endoscopist were enrolled. A total of 200 image files before and after introduction were made and reviewed by three endoscopists. We retrospectively evaluated the utility and safety of Valsalva maneuver.
Results
The visibility before introduction was Good in three cases, Moderate in 12 cases and Poor in 85 cases. Meanwhile, the visibility after introduction was Good in 58 cases, Moderate in 23 cases, and Poor in 19 cases (P < 0.05). Nine lesions including hypopharyngeal cancer were found and adverse events were not observed in this study.
Conclusion
The Valsalva maneuver was considered to be a safe and effective method in endoscopic observation of the pharynx.
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The study protocol was approved by the Institutional Review Board of Toranomon hospital. In this retrospective study, only anonymous data was used, so provision of informed consent was waived.
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Kikuchi, D., Tanaka, M., Suzuki, Y. et al. Utility of Valsalva maneuver in the endoscopic pharyngeal observation. Esophagus 17, 323–329 (2020). https://doi.org/10.1007/s10388-020-00722-z
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DOI: https://doi.org/10.1007/s10388-020-00722-z