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Transnasal-esophagoscopy-slides-050525

Transnasal-esophagoscopy-slides-050525 - Transnasal...

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UTMB Department of Otolaryngology-Head and Neck Surgery Transnasal Esophagoscopy UTMB Otolaryngology Grand Rounds May 25, 2005 Resident: Gordon Shields, MD Faculty: David Teller, MD
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Introduction Dysphagia, laryngopharyngeal reflux, gastroesophageal reflux, globus and cancers of the upper aerodigestive tract are all very common problems seen in Otolaryngology practice Transnasal esophagoscopy can be an adjunctive tool in obtaining a timely diagnosis
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Benefits Complete exam of larynx and esophagus with high resolution under distention No need for sedation – no long recovery or need to miss work Rapid exam Biopsies possible
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Instrument 5.1mm scope with distal video chip, suction, irrigation, biopsy channel Allows easy nasal passage
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Anatomy Extends 18-26cm in posterior mediastinum Impressions from UES, trachea, aorta,left mainstem bronchus left atrium, LES, diaphragm Netter FN. Atlas of Human Anatomy 1997; East Hanover, Novartis. Pg 221.
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UES-junction of inferior pharyngeal constrictor and cricopharyngeus LES- 2cm to 4cm segment of tonically contracted smooth muscle within the diaphragmatic hiatus Vollweiller JF, Vaezi MF. The Esophagus: Anatomy, Physiology, and Diseases. Cummings CW, ed. Otolaryngology Head & Neck Surgery. Phaladelphia: Elsevier Mosby, 2005, 1835-1998.
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Mucosa, submucosa, muscularis propria, and adventitia Inner circular and outer longitudinal muscle Proximal skeletal and distal smooth muscle Netter FN. Atlas of Human Anatomy 1997; East Hanover, Novartis. Pg 229.
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Possible Indications Reflux Globus sensation Dysphagia Head and neck cancer screening Surveillance of Barrett’s esophagus Evaluation of possible foreign body Biopsy of known laryngopharyngeal lesion Placement of tracheoesophageal puncture Tracheoscopy Dilation of esophageal stricture
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Techniques Patient in seated position facing examiner Topical decongestion/anesthesia of nose with 1:1 mixture of 0.05% oxymetazoline and 4% lidocaine Topical anesthesia of oropharynx with 1-2 sprays of 20% benzocaine or 1-2 benzonatate (Tessalon Perles)
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  • Fall '11
  • Dr.Aslam
  • Gastroesophageal reflux disease, Barrett's esophagus, transnasal esophagoscopy, Wilcox CM, Postma GN, WB Saunders pg

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