Screening examination of the larynx and pharynx during upper gastrointestinal panendoscopy

Lehman, Glen A.; Compton, Margaret; Meadows, James R.; Elmore, Michael F.

doi:10.1016/s0016-5107(82)73046-9

Cited by 16 publications

(25 citation statements)

References 3 publications

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“…In the three published studies, no such controls were included (table 2). [3][4][5] In contrast with the positive predictive value, the negative predictive value of our study was 100%. As screening examinations should identify all patients at risk, the sensitivity and negative predictive value of a screening examination are more important statistical parameters than the positive predictive value.…”

Section: Discussioncontrasting

confidence: 92%

“…5 In another study, no cancer lesions were found but two precursor lesions were detected. 3 The other lesions detected in our series were benign, such as chronic laryngitis and Reinke oedema, which are nevertheless of clinical relevance. This is the first prospective study which attempted to determine the rate of false negative examinations.…”

Section: Discussionmentioning

confidence: 57%

“…3 4 Therefore, in the majority of upper gastrointestinal endoscopies, performed with appropriate sedation, visualisation of the laryngopharyngeal area is possible without additional patient discomfort, and little additional time is required to complete the whole examination. 3 In 5% of all endoscopies a pathology was suspected by the gastroenterologist, which was finally confirmed by the Figure 1 A total of 1311 endoscopies were performed during the study period. Reasons for exclusion were: inadequate examination in 94, known pathology in the laryngopharyngeal area in six, video recording not working in four, and insufficient quality of the videotape in 16.…”

Section: Discussionmentioning

confidence: 65%

“…1 2 Three studies, all using fibre endoscopes, have been published that evaluated the diagnostic yield of screening the laryngopharyngeal area during routine UGI endoscopy. [3][4][5] A major drawback of these studies is however that in only one study did an otorhinolaryngologist confirm the pathologies detected by the endoscopists and no study included a control examination to review normal endoscopies. Therefore, the aim our study was to prospectively evaluate the positive and negative predictive value of a screening examination of the laryngopharyngeal area during routine UGI endoscopies using state of the art video endoscopes.…”

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confidence: 99%

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Controlled prospective evaluation of the diagnostic yield of a laryngopharyngeal screening examination during upper gastrointestinal endoscopy

Müllhaupt

2004

Gut

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Background and aims: Examination of the laryngopharyngeal area is not always performed during routine upper gastrointestinal (UGI) endoscopies although older studies reported pathological findings in 0.9-3.5% of cases. The aim of our study was to prospectively evaluate the positive and negative predictive value of screening the laryngopharyngeal area during routine UGI endoscopy. Methods: All patients undergoing elective UGI endoscopy between July 2000 and July 2001 were prospectively enrolled into the study. These patients underwent a careful structured examination of the laryngopharyngeal area, which was videotaped for later blinded review. If a pathological finding was suspected, patients were referred to the study otorhinolaryngologist for further evaluation. In all other cases the videotapes were reviewed by the otorhinolaryngologist, who was blinded to the endoscopic findings. Results: During the study period, 1311 endoscopies were performed in 1209 patients; 1191 were fully evaluated. In 62 endoscopies a pathology in the laryngopharyngeal area was suspected. Forty two were examined by the study otorhinolaryngologist whereas in the remaining 19 only a review of the videotape was possible. In 26 patients pathology was confirmed, corresponding to a positive predictive value of 43% and a negative predictive value of 100%. In one patient (0.08%), an early cancer of the pharyngeal region was detected whereas all other findings were benign lesions. Conclusions: A screening examination of the laryngopharyngeal area should be part of every UGI endoscopy. A serious pathology such as an early cancer may be detected in approximately 1 in 1000 endoscopies.

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Section: Discussioncontrasting

confidence: 92%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 65%

mentioning

confidence: 99%

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Controlled prospective evaluation of the diagnostic yield of a laryngopharyngeal screening examination during upper gastrointestinal endoscopy

Müllhaupt

2004

Gut

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“…In a study by Lehman et al,17 in 1982, screening laryngeal-pharyngeal examinations were performed during 1,120 flexible fiber-optic esophagogastroduodenoscopies. In their series of upper endoscopic examinations, the authors were able to visualize the larynx and pharynx in 82.4% and 78%, respectively.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Rigid and Flexible Esophagoscopy in the Diagnosis of Esophageal Disease: Diagnostic Accuracy, Complications, and Cost

Glaws

Etzkorn

Wenig³

et al. 1996

Ann Otol Rhinol Laryngol

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Rigid esophagoscopy has been used by otolaryngologists for evaluation of the esophagus for over 100 years. Few studies have examined the diagnostic accuracy of rigid esophagoscopy in patients with carcinoma of the head and neck. The goal of our study was to compare the diagnostic accuracy, complication rate, and costs of rigid esophagoscopy and flexible fiber-optic endoscopy in the evaluation of the esophagus in patients with head and neck carcinoma. We retrospectively reviewed the records of 195 patients with head and neck carcinoma who underwent both rigid esophagoscopy and flexible fiber-optic endoscopy within a 6-month period. We discovered 10 cases with discordant findings, of which 5 (50%) were esophageal carcinoma. The estimated cost was less for flexible endoscopy. No complications were reported in either procedure. Our study suggests that flexible fiber-optic endoscopy should replace rigid esophagoscopy in the evaluation of the esophagus in patients with head and neck carcinoma.

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Therapeutic videolaryngoscopy

Cosentino¹,

Morandi²,

Passoni³

et al. 1990

Acta Endosc

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Screening examination of the larynx and pharynx during upper gastrointestinal panendoscopy

Cited by 16 publications

References 3 publications

Controlled prospective evaluation of the diagnostic yield of a laryngopharyngeal screening examination during upper gastrointestinal endoscopy

Controlled prospective evaluation of the diagnostic yield of a laryngopharyngeal screening examination during upper gastrointestinal endoscopy

Comparison of Rigid and Flexible Esophagoscopy in the Diagnosis of Esophageal Disease: Diagnostic Accuracy, Complications, and Cost

Therapeutic videolaryngoscopy

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