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Veltrup R, Kniesburges S, Semmler M. Influence of Perspective Distortion in Laryngoscopy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3276-3289. [PMID: 37652062 DOI: 10.1044/2023_jslhr-23-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
OBJECTIVE An experiment with controllable boundaries was designed to assess the influence of the recording angle and distance on two-dimensional (2D) imaging in laryngoscopy and resulting 2D parameter calculation derived from the glottal area waveform (GAW). METHOD Two high-speed camera setups were used to synchronously record an oscillating synthetic vocal fold (VF) model, simulating a high-speed videoendoscopy. One camera recorded at variable lateral recording angles and a reference camera in superior perspective. This was performed at different physiological recording distances and for two oscillation modes (with/without contacting VFs). The GAW was derived from the segmented glottis, and two parameters each for the categories of symmetry, periodicity, and closure were calculated, as well as two derivative measures. The percentage difference between the variable and reference camera value pairs was calculated, and the angle and height dependencies were quantified using linear regression. RESULTS The visual perception of a laryngoscopy was found to be influenced by the lateral recording angle, which may lead to misinterpretation of VF symmetry among inexperienced observers. The strongest influence of recording angle was observed for symmetry parameters, the strongest being the Amplitude Symmetry Index with up to 2.6%/° (p < .05). A dependence on the recording distance was only found for the Maximum Area Declination Rate. CONCLUSIONS The recording angle in 2D laryngoscopy should be carefully considered during visual inspection of the VF dynamics. Most of the investigated objective parameters were unaffected by the examined perspective distortion. However, especially left-right symmetry measures should only be used under controlled boundary conditions to avoid misdiagnosis and misinterpretation. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23961183.
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Affiliation(s)
- Reinhard Veltrup
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Stefan Kniesburges
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Marion Semmler
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
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Amar PS, Syed KA, Michael RC. The Role of Modified Killian's Method in the Evaluation of Hypopharyngeal and Supraglottic Cancers. South Asian J Cancer 2022; 11:332-335. [PMID: 36756096 PMCID: PMC9902103 DOI: 10.1055/s-0042-1754375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Priyanka Schilling AmarObjectives Hypopharyngeal cancer is one of the upper aerodigestive tract malignancies with the poorest prognosis. The aim of this study was to assess the role of modified Killian's (MK) method in routine, outpatient-based flexible laryngoscopy to improve visualization and assess the extent of supraglottic and hypopharyngeal cancers. Materials and Methods An observational study was conducted in a tertiary hospital in India where fifty consecutive patients who presented to the outpatient clinic with suspected hypopharyngeal and supraglottic malignancy underwent a conventional laryngoscopy as well as MK method. The site and extent of the tumor on endoscopy were recorded and the videos were graded independently by two investigators on Murono's scale from 1 to 5. A subset of these patients who underwent direct laryngoscopy under general anesthesia was also scored with the above scale. The scores were compared to check the accuracy of flexible laryngoscopy with the MK method in staging cancer. Statistical Analysis Descriptive statistics were given using mean (standard deviation [SD]) for continuous variables and frequency (percentage) for categorical variables. The difference between the mean scores was analyzed using the paired-t test. The agreement between the scales and the observer, that is, the inter- and intraobserver agreement, was presented with concordance rate and Kappa weighted analysis. Results In this study, the mean scores of the Murono's scale grading of the conventional method, MK method, and direct laryngoscopy were 1.42 (SD: 0.64), 2.94 (SD: 0.95), and 4.30 (SD: 1.49), respectively, which showed significant improvement in scores with MK method. In addition, the subset analysis demonstrated a significant agreement between direct laryngoscopy and MK method. Conclusion The MK method is a good diagnostic test and a valuable adjunct to diagnostic flexible laryngoscopy in the evaluation and staging of hypopharyngeal and supraglottic cancers.
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Affiliation(s)
- Priyanka Schilling Amar
- Department of Otorhinolaryngology, Christian Medical College, Vellore, Tamil Nadu, India,Address for correspondence Priyanka Schilling Amar MS Department of Otorhinolaryngology and Head & Neck Surgery, Christian Medical CollegeVellore – 632004, Tamil NaduIndia
| | - Kamran Asif Syed
- Department of Otorhinolaryngology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rajiv C. Michael
- Department of Head & Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India
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Fujiwara K, Koyama S, Donishi R, Morisaki T, Fukuhara T, Takeuchi H. Application of an Immobilization Device for the Modified Killian's Method. Yonago Acta Med 2020; 64:12-17. [PMID: 33642899 DOI: 10.33160/yam.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/26/2020] [Indexed: 11/05/2022]
Abstract
Background The hypopharynx is a closed space that is difficult to observe. The modified Killian's (MK) method was introduced to obtain wider exposure. However, this method requires keeping the head forward during the examination. Postural maintenance might be problematic. To use the MK method safely for a thorough endoscopic examination, we introduced a new body immobilization device. The aim of this study was to evaluate the effectiveness of this body immobilization device. Methods Twenty-five patients underwent transnasal laryngoscopy using the MK method with the immobilization device. This device consists of a board to place the chest and a shaft. We classified hypopharynx visualization using a 5-point scale, in various combinations of head torsion, Valsalva maneuver, and MK position. Furthermore, we classified the feasibility of the MK method for 54 patients. Age, BMI, and performance status were evaluated by MK position feasibility class. Results The MK method with the body immobilization device was completed in all patients. It was significantly associated with higher hypopharyngeal visibility score. BMI and performance status were significantly associated with MK method feasibility. There were no significant differences in hypopharynx visualization scores with versus without this device for the patients that could maintain the MK position on their own. Conclusion For patients with poor nutrition or poor ability to perform activities of daily living, it was difficult to maintain the MK position. Thus, this immobilization device might be useful to complete the MK method and provide accurate detection of hypopharyngeal lesions in these patients.
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Affiliation(s)
- Kazunori Fujiwara
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Satoshi Koyama
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Ryohei Donishi
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tsuyoshi Morisaki
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Takahiro Fukuhara
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Hiromi Takeuchi
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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Hosono H, Katada C, Kano K, Kimura A, Tsutsumi S, Miyamoto S, Ichinoe M, Furue Y, Tanabe S, Koizumi W, Yamashita T. Evaluation of the usefulness of upper gastrointestinal endoscopy and the Valsamouth Ⓡ by an otolaryngologist in patients with Hypopharyngeal cancer. Auris Nasus Larynx 2020; 48:265-273. [PMID: 32950326 DOI: 10.1016/j.anl.2020.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/17/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this retrospective study is to evaluate the usefulness of upper gastrointestinal endoscopy and the ValsamouthⓇ by an otolaryngologist in patients with hypopharyngeal cancer to assess the risk. METHODS The study group comprised 41 patients with untreated hypopharyngeal cancer that was precisely diagnosed by an otolaryngologist using upper gastrointestinal endoscopy and the ValsamouthⓇ at our hospital from January 2016 to December 2017. With upper gastrointestinal endoscopy and the ValsamouthⓇ, the oral cavity, oropharynx, larynx, hypopharynx, and esophagus were observed in this order. Narrow-band imaging, and subsequently, white-light observation were performed. At the hypopharynx, vocalization, and subsequently, the Valsalva maneuver were performed. After observing the esophagus, Lugol chromoendoscopy of the esophagus was performed. RESULTS The mean age of the 38 men and 3 women included in the study was 69.7 ± 10.0 years (range, 51-94 years). As for the T category of hypopharyngeal cancer, T1 cancer was observed in 9 patients, T2 cancer in 14, T3 cancer in 11, and T4 cancer in 7. With vocalization, the grade of visualization in the hypopharynx was 1 in 30 patients (73.2%), 2 in 11 patients (26.8%), and 3 or more in 0 patients (0.0%). With the Valsalva maneuver, the grade of visualization in the hypopharynx was 1 in 1 patient (2.4%), 2 in 15 patients (36.6%), 3 in 8 patients (19.5%), 4 in 11 patients (26.8%), and 5 in 6 patients (14.6%). The grade of visualization in the hypopharynx on average was 1.27 after vocalization and 3.15 after the Valsalva maneuver (p < 0.001). With vocalization, the percentage of patients in whom the entire image of hypopharyngeal cancer could be observed was 0.0% for grade 1 and 18.2% for grade 2. With the Valsalva maneuver, the percentage of patients in whom the entire image of hypopharyngeal cancer could be observed was 0.0% for grade 1, 40.0% for grade 2, 50.0% for grade 3, 86.1% for grade 4, and 100% for grade 5. Synchronous esophageal cancers were detected in 17.1% (7/41) of the patients. The grade of Lugol-voiding lesions was A in 5.6%, B in 52.8%, and C in 41.7%. CONCLUSION The examination with upper gastrointestinal endoscopy and the ValsamouthⓇ by an otolaryngologist is feasible in patients with hypopharyngeal cancer. This procedure can detect synchronous esophageal cancer, allowing the risk of metachronous cancer in the head and neck or the esophagus to be recognized after the treatment.
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Affiliation(s)
- Hiroshi Hosono
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Chikatoshi Katada
- Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Koichi Kano
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Akari Kimura
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Shohei Tsutsumi
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Syunsuke Miyamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Masaaki Ichinoe
- Department of Pathology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Yasuaki Furue
- Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Satoshi Tanabe
- Department of Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Wasaburo Koizumi
- Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Taku Yamashita
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
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Kikuchi D, Ikeda M, Murono S. Endoscopic removal of a fish bone foreign body in the hypopharynx with the modified Killian's method. Auris Nasus Larynx 2020; 48:1035-1037. [PMID: 32654797 DOI: 10.1016/j.anl.2020.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/05/2020] [Accepted: 06/17/2020] [Indexed: 11/19/2022]
Abstract
Observing the entire circumference of the hypopharynx is usually difficult because most of the area is anatomically closed in the resting state. The modified Killian's method, consisting of a combination of the modified Killian position, head torsion, and the Valsalva maneuver, is a recently proposed procedure to improve the endoscopic view of the hypopharynx. A fish bone, which was invisible under regular endoscopy but was identified by CT, was successfully observed and removed under the modified Killian's method in a 71-year-old female. This method can be applied to diagnose and treat benign hypopharyngeal disease such as fish bone foreign body in addition to the detection of cancer.
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Affiliation(s)
- Daisuke Kikuchi
- Department of Otolaryngology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Masakazu Ikeda
- Department of Otolaryngology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Shigeyuki Murono
- Department of Otolaryngology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.
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Utility of Valsalva maneuver in the endoscopic pharyngeal observation. Esophagus 2020; 17:323-329. [PMID: 32072359 DOI: 10.1007/s10388-020-00722-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 02/03/2020] [Indexed: 02/03/2023]
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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Politz S, Wagner M, Schwub D, Cattenberg S, Thurnheer R, Schelosky L. Enhancing Visibility of the Hypopharyngeal-Esophageal Region by Introduction of a Physiological Eructation Maneuver. Biomed Hub 2019; 4:1-6. [PMID: 31988967 PMCID: PMC6945956 DOI: 10.1159/000495729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 11/16/2018] [Indexed: 11/21/2022] Open
Abstract
Background In routine medical examination, the hypopharyngeal-esophageal area (HER) is difficult to assess due to its position and anatomical complexity. The purpose of this study was to evaluate the feasibility of a volitional eructation maneuver during transnasal flexible laryngoscopy and its influence on the visibility of the HER. Methods Twenty healthy volunteers underwent flexible laryngoscopy. Once the larynx was freely visible during laryngoscopy, the subjects were asked to trigger a “burp.” The volitional belching during the study was assisted by drinking a carbonated cold drink. The triggered relaxation of the upper esophageal sphincter along with the widening of the hypopharynx region was recorded and subsequently analyzed frame by frame. Results Out of 20 volunteers, 16 (80%) were able to volitionally induce an eructation. Significant widening of the hypopharynx region up to the relaxant upper esophageal sphincter could be recorded. The structures were clearly visible in the offline analysis. In 13 (81%) of the 16 subjects who could induce an eructation, the upper esophageal sphincter was partially visible or free for full inspection. Conclusion The eructation method as a simple physiological function can be used as a complementary method during flexible transnasal endoscopy to enhance visibility of the entire hypopharynx region as well as the upper esophageal sphincter.
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Affiliation(s)
- Svetlana Politz
- Division of Neurology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | | | - Degenhart Schwub
- Division of Otolaryngology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | - Sandra Cattenberg
- Division of Neurology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | - Robert Thurnheer
- Division of Pneumology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | - Ludwig Schelosky
- Division of Neurology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
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Matsui T, Okada T, Kawada K, Okuda M, Ogo T, Nakajima Y, Kume Y, Ryotokuji T, Hoshino A, Tokairin Y, Michi Y, Harada H, Nakajima Y, Kawano T. Detection of Second Primary Malignancies of the Esophagus and Hypophraynx in Oral Squamous Cell Carcinoma Patients. Laryngoscope Investig Otolaryngol 2018; 3:263-267. [PMID: 30186956 PMCID: PMC6119782 DOI: 10.1002/lio2.179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/06/2018] [Accepted: 05/25/2018] [Indexed: 12/11/2022] Open
Abstract
Objective To assess the usefulness of modified esophagogastroduodenoscopy (EGD) for the detection of second primary malignancies of the esophagus or hypopharynx in patients with oral squamous cell carcinoma and determine the association between the oral lesion subsite and esophageal or hypopharyngeal lesion occurrence. Study Design Retrospective review. Methods In total, 166 patients with oral squamous cell carcinoma without any established symptoms of esophageal or hypopharyngeal squamous cell carcinoma underwent modified EGD based on the Valsalva maneuver and U-turn method, image-enhanced endoscopy, and chromoendoscopy using Lugol's iodine for diagnosis. All suspected lesions were biopsied to determine the clinical stages and duplication rates. Odds ratios for the occurrence of duplicate lesions according to the oral lesion subsite were determined. Results In total, 37 esophageal and 16 hypopharyngeal lesions were detected. According to the Union for International Cancer Control/American Joint Committee on Cancer classification (2009), 75.7% and 5.4% esophageal lesions were classified as stage IA and IB, respectively, and 50% and 18.8% hypopharyngeal lesions as stage II and stage I, respectively. Approximately 59.1% and 50% esophageal and hypopharyngeal lesions, respectively, were successfully treated by endoscopic resection. Oral lesions involving the floor of the mouth were more frequently accompanied by second primary malignancies of the esophagus or hypopharynx. Conclusions Modified EGD is an effective noninvasive technique for early diagnosis and treatment of second primary malignancies of the esophagus and hypopharynx in patients with oral squamous cell carcinoma. In particular, patients with floor of the mouth lesions need close monitoring for hypopharyngeal and esophageal lesions. Level of Evidence 3b.
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Affiliation(s)
- Toshihiro Matsui
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Takuya Okada
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Kenro Kawada
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Masahumi Okuda
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Taichi Ogo
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yutaka Nakajima
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yuichiro Kume
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Tairo Ryotokuji
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Akihiro Hoshino
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yutaka Tokairin
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yasuyuki Michi
- Department of Maxillofacial Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Tokyo Japan
| | - Hiroyuki Harada
- Department of Oral & Maxillofacial Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Tokyo Japan
| | - Yasuaki Nakajima
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
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Sakai A, Okami K, Ebisumoto K, Yamamoto H, Saito K, Maki D, Furuya H, Iida M. How to improve the endoscopic view of the hypopharynx: Validation of our novel modified Killian's Method to expose the hypopharynx in 20 subjects. Clin Otolaryngol 2018; 43:1407-1410. [PMID: 29920948 DOI: 10.1111/coa.13172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 11/30/2022]
Affiliation(s)
- A Sakai
- Department of Otolaryngology, School of Medicine, Tokai University, Isehara, Japan
| | - K Okami
- Department of Otolaryngology, School of Medicine, Tokai University, Isehara, Japan
| | - K Ebisumoto
- Department of Otolaryngology, School of Medicine, Tokai University, Isehara, Japan
| | - H Yamamoto
- Department of Otolaryngology, School of Medicine, Tokai University, Isehara, Japan
| | - K Saito
- Department of Otolaryngology, School of Medicine, Tokai University, Isehara, Japan
| | - D Maki
- Department of Otolaryngology, School of Medicine, Tokai University, Isehara, Japan
| | - H Furuya
- Basic Clinical Science and Public Health, School of Medicine, Tokai University, Isehara, Japan
| | - M Iida
- Department of Otolaryngology, School of Medicine, Tokai University, Isehara, Japan
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Fukuhara T, Matsuda E, Hattori Y, Donishi R, Ehara H, Fujiwara K, Takeuchi H. Usefulness of ultrasound for assessing the primary tumor of hypopharyngeal carcinoma. Laryngoscope Investig Otolaryngol 2017; 2:390-394. [PMID: 29299513 PMCID: PMC5743166 DOI: 10.1002/lio2.126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/02/2017] [Accepted: 10/24/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives To clarify the usefulness of ultrasonography for detecting hypopharyngeal cancer. Study Design Cross-sectional study. Methods The study included 95 patients who underwent pre-treatment ultrasonography. We evaluated the usefulness of ultrasonography for detecting primary hypopharyngeal carcinoma of each T stage and subsite, and for assessing extrahypopharyngeal invasion. Additionally, we determined the efficacy of color Doppler for evaluating primary hypopharyngeal carcinoma. Results The patients comprised 93 men and 2 women with a mean age of 67.5 years. The T stage (primary tumors) was T1 in 29 patients, T2 in 22, T3 in 9, and T4 in 35. Primary sites with a T stage over T3 were detected using ultrasonography in 17 patients.Regarding primary subsites, postcricoid tumors were assessed most easily (64%), while posterior wall tumors were the most difficult to assess (25%). In 15 of 17 patients, the evaluation of extrahypopharyngeal invasion by ultrasonography matched up precisely with computed tomography findings. In addition, abnormally increased blood flow in primary hypopharyngeal cancers was recognized by color Doppler, and could be used to predict subsites. Conclusions Cancers at T3 and T4 hypopharyngeal primary tumors and their extrahypopharyngeal invasion were detectable using ultrasonography. Furthermore, ultrasonography was useful for assessing postcricoid tumors that were difficult to observe by flexible laryngoscopy. Level of Evidence 4.
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Affiliation(s)
- Takahiro Fukuhara
- Department of Otolaryngology, Head and Neck SurgeryTottori University Faculty of MedicineYonagoTottoriJapan
| | - Eriko Matsuda
- Department of Otolaryngology, Head and Neck SurgeryTottori University Faculty of MedicineYonagoTottoriJapan
| | - Yuiko Hattori
- Department of Otolaryngology, Head and Neck SurgeryTottori University Faculty of MedicineYonagoTottoriJapan
| | - Ryohei Donishi
- Department of Otolaryngology, Head and Neck SurgeryTottori University Faculty of MedicineYonagoTottoriJapan
| | - Hiroaki Ehara
- Department of Otolaryngology, Head and Neck SurgeryTottori University Faculty of MedicineYonagoTottoriJapan
| | - Kazunori Fujiwara
- Department of Otolaryngology, Head and Neck SurgeryTottori University Faculty of MedicineYonagoTottoriJapan
| | - Hiromi Takeuchi
- Department of Otolaryngology, Head and Neck SurgeryTottori University Faculty of MedicineYonagoTottoriJapan
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Preoperative identification of the internal opening with the modified Killian's method in a case of pyriform sinus fistula. Am J Otolaryngol 2016; 37:38-40. [PMID: 26700258 DOI: 10.1016/j.amjoto.2015.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 09/08/2015] [Indexed: 01/20/2023]
Abstract
Pyriform sinus fistula is a rare branchial pouch anomaly, which causes recurrent neck abscess. Although complete excision of the fistula tract is considered as a definitive treatment for pyriform sinus fistula, it has been suggested that chemocauterization with trichloroacetic acid (TCA) of the internal opening is a reasonable treatment. For this purpose identifying the existence of an internal opening is important. Here, we describe the Modified Killian's method, a recently proposed simple endoscopic technique to observe a wider area of the hypopharyngeal space, and show that it is helpful to identify the internal opening of the pyriform sinus fistula. The Modified Killian's method is a suitable examination for pyriform sinus fistula prior to TCA chemocauterization.
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