Intra-oropharyngeal U-turn Method (for Observing the Radix Linguae) with Trans-nasal Endoscopy

Abstract

Introduction : The more progress achieved in endoscopy, the more superficial cancers in the head and neck regions have been found. There are, however, some areas difficult to observe with trans-oral endoscopy.
Objective : In order to observe the radix linguae in detail, the intra-oropharyngeal U-turn method with trans-nasal endoscopy was used. Its efficacy is reported here.
Equipments : The types of upper endoscopes used were EG-580 NW and EG-530 NW (FUJI FILM, Tokyo). These endoscopes have a visual angle of 140 degrees. Their tip can make a U-turn up to an angle of 210 degrees.
Subjects and methods : One hundred and seventy-two patients underwent the intra-oropharyngeal U-turn method with trans-nasal endoscopy from April to October 2012. After observation of the oral cavity by trans-oral endoscope, the endoscope was inserted through the nose. When the tip of the endoscope reached caudal to the uvula, the patient opened his mouth wide, stuck his tongue forward as much as possible and made a vocal sound like “ayyy.” The endoscopist caused the endoscope to U-turn and observed the oropharynx, in particular the radix linguae. In recorded videos other endoscopists later assessed whether all areas of the tongue from the radix linguae to the apex linguae were observed or not.
Results : All areas of the tongue from the radix linguae to the apex linguae could be observed in 160 cases (93%), and a frontal view of the papillae vallatae could be obtained.
Conclusion : The intra-oropharyngeal U-turn method with trans-nasal endoscopy is useful for observing the oropharynx, in particular the radix linguae, in detail.