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


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.

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Kawada, K. , Kawano, T. , Sugimoto, T. , Matsui, T. , Okuda, M. , Ogo, T. , Kume, Y. , Nakajima, Y. , Saito, K. , Fujiwara, N. , Ryotokuji, T. , Miyawaki, Y. , Tokairin, Y. , Nakajima, Y. , Nagai, K. and Ito, T. (2015) Case of a Superficial Hypopharyngeal Cancer at the Pharyngoesophageal Junction Which Is Detected by Transnasal Endoscopy Using Trumpet Maneuver. Open Journal of Gastroenterology, 5, 1-6. doi: 10.4236/ojgas.2015.51001.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Shah, J.P., Shaha, A.R., Spiro, R.H., et al. (1976) Carcinoma of the Hypopharynx. The American Journal of Surgical Pathology, 132, 439-443.
[2] Muto, M., Nakane, M., Katada, C., et al. (2004) Squamous Cell Carcinoma in Situ at Oropharyngeal and Hypopharyngeal Mucosal Sites. Cancer, 101, 1375-1381.
[3] Muto, M., Katada, C., Sano, Y., et al. (2005) Narrow Band Imaging: A New Diagnostic Approach to Visualize Angiogenesis in Superficial Neoplasia. Clinical Gastroenterology and Hepatology, 3, 16-20.
[4] Muto, M., Minashi, K., Yano, T., et al. (2010) Early Detection of Superficial Squamous Cell Carcinoma in the Head and Neck Region and Esophagus by Narrow Band Imaging: A Multicenter Randomized Controlled Trial. Journal of Clinical Oncology, 28, 1566-1572.
[5] Watanabe, A., Tsujie, H., Taniguchi, M., et al. (2006) Laryngoscopic Detection of Pharyngeal Carcinoma in Situ with Narrowband Imaging. The Laryngoscope, 116, 650-654.
[6] Watanabe, A., Taniguchi, M., Tsujie, H., et al. (2008) The Value of Narrow Band Imaging Endoscope for Early Head and Neck Cancers. Otolaryngology-Head and Neck Surgery, 138, 446-451.
[7] Spraggs, P.D. and Harries, M.L. (1995) The Modified Valsalva Maneuver to Improve Visualization of the Hypopharynx during Flexible Nasopharyngoscopy. Journal of Laryngology and Otology, 109, 863-864.
[8] Purser, S. and Antippa, P. (1995) Maneuver to Assist Examination of the Hypopharynx. Head Neck, 17, 389-393.
[9] Hillel, A.D. and Schwartz, A.N. (1989) Trumpet Maneuver for Visualization and CT Examination of the Pyriform Sinus and Retrocricoid Area. Head Neck, 11, 231-236.
[10] Colquhoun-Flannery, W., Davis, A. and Carruth, J.A.S. (2000) Improving the Endoscopic View of the Hypopharynx with Anterior Neck Traction during the Trumpet Manoeuvre. Journal of Laryngology and Otology, 114, 283-284.
[11] Williams, R.S., Lancaster, J., Karagama, Y., et al. (2004) A Systematic Approach to the Nasendoscopic Examination of the Larynx and Pharynx. Clinical Otolaryngology & Allied Sciences, 29, 175-178.
[12] Morita, M., Kuwano, H., Ohno, S., et al. (1994) Multiple Occurrence of Carcinoma in the Upper Aerodigestive Tract Associated with Esophageal Cancer: Reference to Smoking, Drinking and Family History. International Journal of Cancer, 58, 207-210.

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