Case of a Superficial Hypopharyngeal Cancer at the Pharyngoesophageal Junction Which Is Detected by Transnasal Endoscopy Using Trumpet Maneuver

Kenro Kawada^1*, Tatsuyuki Kawano¹, Taro Sugimoto², Toshihiro Matsui¹, Masafumi Okuda¹, Taichi Ogo¹, Yuuichiro Kume¹, Yutaka Nakajima¹, Katsumasa Saito¹, Naoto Fujiwara¹, Tairo Ryotokuji¹, Yutaka Miyawaki¹, Yutaka Tokairin¹, Yasuaki Nakajima¹, Kagami Nagai¹, Takashi Ito³

¹Department of Esophageal and General Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
²Department of Otorhinolaryngology, Tokyo Medical and Dental University, Tokyo, Japan.
³Department of Human Pathology, Tokyo Medical and Dental University, Tokyo, Japan.

DOI: 10.4236/ojgas.2015.51001                

Abstract

Aims: In order to observe the pharyngoesophageal junction, the trumpet maneuver with trans-nasal endoscopy was used. Its efficacy is reported here. Material and Methods: A 71-year-old man who underwent esophagectomy in esophageal cancer 2 years ago was admitted to our hospital with primary pharyngeal cancer. The type of upper endoscope used was EG-580NW (FUJI Film, Tokyo, Japan). The endoscope is a trans-nasal endoscope that can provide high quality endoscopic images. The pharyngeal cancer located at right lateral wall which was previously detected could be observed easily. We asked the patient to blow hard and puff his cheeks with his mouth closed. When inspecting the hypopharynx and the orifice of the esophagus, we told the patient that we would start the trumpet maneuver. Results: After the trumpet maneuver, the pharyngeal mucosa was stretched out. Another primary lesion was observed at the posterior wall of the hypopharynx near the pharyngoesophageal junction. This technique provided a much better view of the lesion than had been possible with trans-oral endoscopy，allowing us to remove the biopsy specimen without sedation. Conclusion: In conclusion, the trumpet maneuver using trans-nasal endoscopy is a useful technique for precise inspection before treatments for patients who have already detected the lesions.

Keywords

Superficial Pharyngeal Cancer, Transnasal Endoscopy, Trumpet Maneuver

Conflicts of Interest

The authors declare no conflicts of interest.

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