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Novel laryngoscopic strategies to improve evaluation of the site and extent of primary hypopharyngeal tumours

Published online by Cambridge University Press:  13 August 2013

X-G Ni ,
R-R Cheng ,
S-Q Lai ,
L Zhang ,
S He ,
Y-M Zhang  and
G-Q Wang
X-G Ni
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
R-R Cheng
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
S-Q Lai
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
L Zhang
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
S He
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
Y-M Zhang
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
G-Q Wang*
Affiliation:
Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
*
Address for correspondence: Dr Gui-Qi Wang, Department of Endoscopy, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, 17 Panjiayuan, Chaoyang District, PO Box 2258, Beijing 100021, PR China Fax: +86 10 87711782 E-mail: [email protected]
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Abstract

Objective:

To investigate different strategies for displaying the hypopharynx and oesophageal entrance during laryngoscopy for hypopharyngeal cancer.

Patients and methods:

A total of 113 patients with hypopharyngeal cancer underwent laryngoscopy prior to surgery. The hypopharynx was displayed by: (1) pulling the anterior cervical skin; (2) having the patient perform the Valsalva balloon-blowing manoeuvre; and (3) injecting oxygen through the biopsy channel to expose the oesophageal entrance. The effect of these methods on visualisation of primary tumour size and extent was assessed.

Results:

During pronunciation of the letter ‘e', the hypopharynx was displayed in only 33 patients (29.2 per cent); with anterior cervical skin traction plus the balloon-blowing manoeuvre, the hypopharynx was displayed in 106 patients (93.8 per cent; p < 0.001). The combined strategy was superior especially when judging the extent of posterior pharyngeal wall and postcricoid invasion. Oesophageal entrance involvement was visible in 33 patients upon injecting oxygen through the laryngoscopic biopsy channel, and in 25 patients during radiological examination; laryngoscopy was superior to radiological examination in determining the extent of oesophageal entrance invasion (p = 0.003).

Conclusion:

Adequate laryngoscopic display of the hypopharynx could increase the accuracy of pre-treatment hypopharyngeal cancer staging.

Keywords

Hypopharyngeal NeoplasmsLaryngoscopyNeoplasm Staging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 9 , September 2013 , pp. 882 - 889
Copyright
Copyright © JLO (1984) Limited 2013 

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