PMID- 32258376
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 4
DP  - 2020 Apr
TI  - Usefulness of a dedicated mouthpiece for the Valsalva maneuver to visualize the 
      hypopharynx during transoral endoscopy.
PG  - E536-E543
LID - 10.1055/a-1099-9130 [doi]
AB  - Background and study aims  Patients with esophageal squamous cell carcinoma (SCC) 
      are at high risk of developing second primary SCCs in the hypopharynx. However, 
      such second primary tumors are difficult to observe because of lumen closure. The 
      Valsalva maneuver using a dedicated mouthpiece is a promising technique to 
      visualize the hypopharynx during transoral endoscopy. In the current study, we 
      investigated the utility of this method. Patients and methods  The current study 
      was a randomized, controlled, crossover trial. Patients with esophageal SCC were 
      randomly assigned first to undergo pharyngeal observation using the dedicated 
      mouthpiece followed by observation using a conventional mouthpiece, or vice 
      versa. The primary endpoint was complete visualization of the hypopharynx, which 
      was assessed blindly by three external evaluators. Results  A total of 68 
      pharyngeal examinations were analyzed - 34 with the dedicated mouthpiece and 34 
      with a conventional mouthpiece. Complete visualization was achieved in 68 % of 
      the examinations (23/34) using the dedicated mouthpiece, whereas none of the 
      examinations using the conventional mouthpiece achieved complete visualization of 
      the hypopharynx. Observation scores of the oropharynx were not significantly 
      different between both types of examination ( P  = 0.50). No serious adverse 
      events (AEs) occurred. Conclusions  Endoscopic view of the hypopharynx was 
      markedly improved by the Valsalva maneuver using the dedicated mouthpiece, with 
      no serious AEs. This procedure should be included in the endoscopic examinations 
      for the patients with esophageal SCCs.
FAU - Kato, Minoru
AU  - Kato M
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Hayashi, Yoshito
AU  - Hayashi Y
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Uema, Ryotaro
AU  - Uema R
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Saiki, Hirotsugu
AU  - Saiki H
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Kimura, Keiichi
AU  - Kimura K
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Inoue, Takanori
AU  - Inoue T
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Sakatani, Akihiko
AU  - Sakatani A
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Yoshii, Shunsuke
AU  - Yoshii S
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Tsujii, Yoshiki
AU  - Tsujii Y
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Shinzaki, Shinichiro
AU  - Shinzaki S
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Hida, Eisuke
AU  - Hida E
AD  - Department of Biostatics and Data Science, Osaka University Graduate School of 
      Medicine, Suita, Japan.
FAU - Iijima, Hideki
AU  - Iijima H
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
FAU - Takehara, Tetsuo
AU  - Takehara T
AD  - Department of Gastroenterology and Hepatology, Osaka University Graduate School 
      of Medicine, Suita, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200323
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7089799
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2020/04/08 06:00
MHDA- 2020/04/08 06:01
PMCR- 2020/04/01
CRDT- 2020/04/08 06:00
PHST- 2019/09/06 00:00 [received]
PHST- 2019/12/02 00:00 [accepted]
PHST- 2020/04/08 06:00 [entrez]
PHST- 2020/04/08 06:00 [pubmed]
PHST- 2020/04/08 06:01 [medline]
PHST- 2020/04/01 00:00 [pmc-release]
AID - 10.1055/a-1099-9130 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Apr;8(4):E536-E543. doi: 10.1055/a-1099-9130. Epub 2020 Mar 
      23.