Sato Kiminori, Nakashima Tadashi
Department of Otolaryngology-Head and Neck Surgery, Kurume University, School of Medicine, Japan.
Am J Otolaryngol. 2004 May-Jun;25(3):167-72. doi: 10.1016/j.amjoto.2003.12.005.
The videoendoscope has a small charge-coupled device (CCD) chip built into its tip that provides a clear image. This report concerns office-based pharyngeal and laryngeal foreign-body management using a videoendoscope.
Three types of videoendoscopes (videoendoscopes equipped with and also without a hood at their tips and a rigid videoendoscope) were used in this study. Seventeen patients who complained of pharyngeal and laryngeal foreign bodies were treated with these videoendoscopes.
The advantages of this intervention were (1) videoendoscopes presented clear dynamic color images on a color video monitor and provided excellent resolution and recording and thus yielded high diagnostic accuracy and fine intervention; (2) the videoendoscope's diameter was relatively small and resulted in less discomfort for patients, even for children; (3) patients could be examined and treated in a sitting position on a procedure chair at the otolaryngology outpatient clinic, which obviated general anesthesia; (4) the videoendoscope equipped with a hood enabled treatment in a closed cavity like the hypopharynx; (5) minute foreign bodies located at the portion of the pharynx, which were hard to examine, could be depicted clearly; (6) pernasal endoscopy allowed the doctor to examine patients who had a strong gag reflex; and (7) good image documentation on the color video monitor allowed the physician to carry out safe intervention. A disadvantage of this procedure was that the extraction of different kinds of foreign bodies was limited, but it depended in part on the efficacy of the forceps.
Foreign-body extraction using a videoendoscope is one of the reliable procedures that has widened the indications for office-based endoscopy.
视频内窥镜在其尖端内置有一个小型电荷耦合器件(CCD)芯片,可提供清晰图像。本报告涉及使用视频内窥镜在门诊环境下处理咽喉部异物。
本研究使用了三种类型的视频内窥镜(尖端配备和未配备罩子的视频内窥镜以及硬管视频内窥镜)。对17例主诉咽喉部有异物的患者使用这些视频内窥镜进行治疗。
该干预措施的优点包括:(1)视频内窥镜在彩色视频监视器上呈现清晰的动态彩色图像,具有出色的分辨率和记录功能,因此诊断准确性高且干预效果好;(2)视频内窥镜直径相对较小,即使对儿童患者也能减少不适;(3)患者可在耳鼻喉科门诊的检查椅上坐姿接受检查和治疗,无需全身麻醉;(4)配备罩子的视频内窥镜能够在下咽等封闭腔内进行治疗;(5)位于咽部难以检查部位的微小异物能够清晰显示;(6)经鼻内窥镜检查可用于有强烈 gag 反射的患者;(7)彩色视频监视器上良好的图像记录便于医生进行安全干预。该操作的一个缺点是不同种类异物的取出受到限制,但部分取决于镊子的效果。
使用视频内窥镜进行异物取出是一种可靠的操作方法,拓宽了门诊内窥镜检查的适应证。