Bacon C K, Hendrix R A
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia.
Ann Otol Rhinol Laryngol. 1992 Feb;101(2 Pt 1):147-55. doi: 10.1177/000348949210100208.
Open tube esophagoscopy is the mainstay of otolaryngic esophageal examination. Over the last 30 years flexible endoscopes have become popular and are challenging the open tube esophagoscope for use in otolaryngic practice. This study examines all open tube esophagoscopies performed on adult patients at the University of Pennsylvania over an 8-year period for the diagnosis and treatment of foreign bodies, strictures, functional disorders, and carcinoma. Open tube esophagoscopy is most useful for foreign body extraction, examination of the cervical esophagus, and dilation of pliable strictures. For most other indications flexible esophagoscopy provides improved visualization with lower morbidity. For patients with squamous cell carcinoma of the head and neck we found a 1.4% incidence of secondary esophageal malignancies and a 28% incidence of false-negative barium swallow studies. We recommend esophagoscopy for all patients with carcinoma of the upper aerodigestive tract. The otolaryngologist should be adept at both flexible and open tube esophagoscopy in order to allow optimal examination of and therapeutic intervention in the upper aerodigestive tract.
开放式食管镜检查是耳鼻喉科食管检查的主要手段。在过去30年里，可弯曲内镜已变得流行起来，并正在挑战开放式食管镜在耳鼻喉科实践中的应用。本研究调查了宾夕法尼亚大学在8年时间里对成年患者进行的所有开放式食管镜检查，以诊断和治疗异物、狭窄、功能障碍和癌症。开放式食管镜检查对于异物取出、颈段食管检查以及柔韧性狭窄的扩张最为有用。对于大多数其他适应证，可弯曲食管镜检查能提供更好的视野且发病率更低。对于头颈部鳞状细胞癌患者，我们发现继发性食管恶性肿瘤的发生率为1.4%，钡餐检查假阴性的发生率为28%。我们建议对上呼吸道消化道癌患者均进行食管镜检查。耳鼻喉科医生应熟练掌握可弯曲和开放式食管镜检查，以便对上呼吸道消化道进行最佳检查和治疗干预。
