瓦尔萨尔瓦动作（valsalva maneuver）在经内镜观察咽中的效用。
Utility of Valsalva maneuver in the endoscopic pharyngeal observation.
机构信息
Department of Gastroenterology, Toranomon hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, Japan.
Department of Otorhinolaryngology, Toranomon hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, Japan.
出版信息
Esophagus. 2020 Jul;17(3):323-329. doi: 10.1007/s10388-020-00722-z. Epub 2020 Feb 18.
BACKGROUND
Metachronous cancer rate in the pharynx is high before and after the treatment of esophageal cancer. Endoscopic observation is difficult in the pharynx especially in the postcricoid area. Pharyngeal cancer in the postcricoid area has been often found in advanced stage. Valsalva maneuver has been reported to improve the visibility.
METHODS
From May 2017 we introduced a dedicated mouthpiece to conduct Valsalva maneuver. One hundred consecutive patients who had been observed throughout the pharynx by one endoscopist were enrolled. A total of 200 image files before and after introduction were made and reviewed by three endoscopists. We retrospectively evaluated the utility and safety of Valsalva maneuver.
RESULTS
The visibility before introduction was Good in three cases, Moderate in 12 cases and Poor in 85 cases. Meanwhile, the visibility after introduction was Good in 58 cases, Moderate in 23 cases, and Poor in 19 cases (P < 0.05). Nine lesions including hypopharyngeal cancer were found and adverse events were not observed in this study.
CONCLUSION
The Valsalva maneuver was considered to be a safe and effective method in endoscopic observation of the pharynx.
背景
食管癌治疗前后咽部的继发癌发生率较高，咽部尤其是环后区内镜观察较为困难，常导致该区域的癌症发现较晚。有报道称瓦尔萨尔瓦动作可改善咽部的可视性。
方法
自 2017 年 5 月起，我们引入专用的口腔镜来进行瓦尔萨尔瓦动作。共纳入 100 例连续接受同一位内镜医生进行全咽部观察的患者。在引入前后共拍摄了 200 张图像文件，并由 3 位内镜医生进行了回顾性评估。我们回顾性评估了瓦尔萨尔瓦动作的实用性和安全性。
结果
引入前的可视性良好者 3 例，中度者 12 例，差者 85 例。而引入后的可视性良好者 58 例，中度者 23 例，差者 19 例（P<0.05）。本研究中发现了 9 个病灶，包括下咽癌，未观察到不良事件。
结论
瓦尔萨尔瓦动作被认为是一种安全有效的咽部内镜观察方法。
Zotero 插件