title: Use of transoral endoscopy for pharyngeal examination: cross-sectional analysis.
abstract: OBJECTIVE
  Transoral endoscopy with narrow band imaging (NBI) is useful for identifying early-stage head and neck cancer. However, the screening capability of transoral upper gastrointestinal endoscopy has not yet been systematically evaluated. We evaluated the usefulness of transoral upper gastrointestinal endoscopy for pharyngeal examination.
  
  
  METHODS
  This cross-sectional study evaluated 480 patients. All endoscopic pharyngeal examinations with NBI were carried out in accordance with prescribed procedures, consisting of 10 images each and all images were assessed by a blinded reviewer. We examined the association between the diagnostic usefulness of pharyngeal examination and other factors.
  
  
  RESULTS
  Median subject age was 64 years (range 22-90 years), and 64% were male. Almost all patients (98%) had an Eastern Cooperative Oncology Group Performance Status of 0 or 1.Butylscopolamine bromide was given to 382 patients (80%), and a sedative was given to 460 (96%) patients. Median observation time was 74 s (range, 16-362 s), resulting in a mean of 9.0 usable images per patient. However, photographs of the right and left pyriform sinuses were consistently poor. Ordered logistic regression analysis showed that quality images were positively correlated with increased patient age.
  
  
  CONCLUSIONS
  Transoral endoscopic examination was possible in most patients for screening of the head and neck. However, results were poor in the pyriform sinuses, indicating that additional improvements of examination methods and instruments are needed to enhance screening accuracy.
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsuji
authors.forename: Hisashi
authors.initials: H
authors.lastname: Doyama
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Takeda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takemura
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yoshida
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kito
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Asahina
authors.forename: Renma
authors.initials: R
authors.lastname: Ito
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nakanishi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hayashi
authors.forename: Satoko
authors.initials: S
authors.lastname: Inagaki
authors.forename: Kei
authors.initials: K
authors.lastname: Tominaga
authors.forename: Yohei
authors.initials: Y
authors.lastname: Waseda
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Tsuji
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamada
authors.forename: Shoryoku
authors.initials: S
authors.lastname: Hino
authors.forename: Toshihide
authors.initials: T
authors.lastname: Okada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009055:Mouth; D062048:Narrow Band Imaging; D057605:Natural Orifice Endoscopic Surgery; D010610:Pharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult
keywords: gastrointestinal endoscopy; head and neck cancer; mass screening; narrow band imaging (NBI)