OBSERVATION TECHNIQUE AND DIAGNOSIS FOR SUPERFICIAL CANCER IN THE HEAD AND NECK FIELD DURING UPPER GASTROINTESTINAL ENDOSCOPY

Abstract

Fen gastrointestinal (GI) endoscopists have considered the early detection of head and neck cancer during upper GI endoscopy. However, the patient's background and risk factor are similar between esophageal cancer and head and neck cancer, therefore we have experienced some synchronous or metachronous double cancer cases in clinical practice. In addition, it has been reported that carcinoma in situ of the oropharynx and hypopharynx which was undetectable with the conventional endoscope, could be detected with a narrow band imaging (NBI) endoscopy system. If head and neck cancer can be detected at the early stage, it can be treated with endoscopic resection sparing the patient's pharynx, speaking and swallowing functions. This is very important from the point of organ preservation and the patient's quality of life. In order not to overlook lesions, systematic observation of the head and neck field is important during upper GI endoscopy. Furthermore, delicate endoscopic observation is advocated because it can easily cause pharyngeal reflex and makes observation difficult. The point of diagnosis for superficial head and neck cancer is “a well demarcated brownish area” with NBI observation, and “increased density of extended micro-capillaries” with magnifying observation. In this study, we would like to describe the details of our observation technique and diagnosis for superficial cancer in head and neck field during upper GI endoscopy.