Comparison between two valsalva techniques for improvement of hypopharyngeal nasendoscopy: a preliminary communication

Freeman, Simon; Keith, Andrew O.; Aucott, W.; Kazmi, Nosheen; Nigam, A.

doi:10.1111/j.1749-4486.2007.01559.x

Cited by 11 publications

(9 citation statements)

References 5 publications

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“…In the pre-therapeutic evaluation, transnasal endoscopic observation is performed routinely with Valsalva maneuver and head torsion to gain a maximally expanded intraluminal view of the hypopharynx [35–37]. This method enables accurate visualization of tumor extension on the mucosal surface and detailed inspection of the hypopharynx for any other possible lesion down to the esophageal entrance (Fig.…”

Section: Methodsmentioning

confidence: 99%

Clinical outcomes of transoral videolaryngoscopic surgery for hypopharyngeal and supraglottic cancer

et al. 2017

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BackgroundTransoral videolaryngoscopic surgery (TOVS) was developed as a new distinct surgical procedure for hypopharyngeal cancer (HPC) and supraglottic cancer (SGC) staged at up to T3. However, long-term treatment outcomes of TOVS remain to be validated.MethodsUnder a straight broad intraluminal view provided by combined use of a distending laryngoscope and a videolaryngoscope, we performed en bloc tumor resection via direct bimanual handling of the ready-made straight-form surgical instruments and devices. We retrospectively analyzed functional and oncologic outcomes of 72 patients with HPC (n = 58) or SGC (n = 14) whose minimum follow-up was 24 months or until death.ResultsThe cohort comprised nine patients of Tis, 23 of T1, 33 of T2, and 7 of T3. Among 36 patients (50%) who underwent neck dissection simultaneously, all but one were pathologically node-positive. Twelve patients underwent postoperative concurrent chemoradiation (CCRT) as adjuvant treatment, and another four patients underwent radiation or CCRT for second or later primary cancer. The endotracheal tube was removed in an operation room in all but two patients who underwent temporary tracheostomy. Pharyngeal fistula was formed transiently in two patients. The median time until patients resumed oral intake and could take a soft meal was 2 and 5 days, respectively. Eventually, 69 patients (96%) took normal meals. The 5-year cause-specific survival (CSS), overall survival (OS), larynx-preserved CSS, and loco-regional controlled CSS were 87.3%, 77.9%, 86.0%, and 88.0%, respectively. Multivariate analysis revealed N2-3 as an independent prognostic factor in both CSS (hazard ratio [HR] = 25.51, P = 0.008) and OS (HR = 4.90, P = 0.022), which indirectly reflected higher risk of delayed distant metastasis.ConclusionsConsidering its sound functional and oncological outcomes with various practical advantages, TOVS can be a dependable, less invasive, and cost-effective surgical option of an organ-function preservation strategy for HPC and SGC.

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Section: Methodsmentioning

confidence: 99%

Clinical outcomes of transoral videolaryngoscopic surgery for hypopharyngeal and supraglottic cancer

et al. 2017

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“…One possible approach is pneumatic dilatation using the trumpet maneuver or Valsalva maneuver during endoscopic examination. The UES is visible in up to 20% of patients using one of these procedures [7]. Both methods do not differ significantly in terms of their effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…Other procedures, some of which are also used in combination with the aforementioned maneuvers, attempt to dilate the anatomical structures of the hypopharynx with gas. Well-known examples are the trumpet maneuver and the Valsalva maneuver [7]. …”

Section: Introductionmentioning

confidence: 99%

Enhancing Visibility of the Hypopharyngeal-Esophageal Region by Introduction of a Physiological Eructation Maneuver

et al. 2019

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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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“…During its evolution, many strategies have been described to optimise the view gained by the examiner . Many of these focus on improving the view of the hypopharynx due to the oncological importance of this site . However, as far as we are aware, there have been no reported techniques aimed at improving the view of the subglottis.…”

Section: Introductionmentioning

confidence: 99%

A manoeuvre to enhance subglottic view during flexible laryngoscopy

Cherko

Ghufoor

2016

Clinical Otolaryngology

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Comparison between two valsalva techniques for improvement of hypopharyngeal nasendoscopy: a preliminary communication

Abstract: The nasal valsalva and the trumpet manoeuvre with anterior neck skin traction are complementary techniques for improving the view of the hypopharynx.

Cited by 11 publications

References 5 publications

Clinical outcomes of transoral videolaryngoscopic surgery for hypopharyngeal and supraglottic cancer

Clinical outcomes of transoral videolaryngoscopic surgery for hypopharyngeal and supraglottic cancer

Enhancing Visibility of the Hypopharyngeal-Esophageal Region by Introduction of a Physiological Eructation Maneuver

A manoeuvre to enhance subglottic view during flexible laryngoscopy

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