A systematic approach to the nasendoscopic examination of the larynx and pharynx

Several nasendoscopic techniques have been described to improve the view of different anatomical subsites when assessing the laryngopharynx. A prospective study was undertaken to compare and evaluate the views obtained with each of the different techniques employed in the nasendoscopic examination of the upper aero-digestive tract. No visualization manoeuvres were found to be beneficial in improving the view of the tongue base; however, tongue protrusion did improve the view of the valleculae. Both the post-cricoid and the upper oesophageal sphincter were best seen when the trumpet manoeuvre was performed along with skin traction of the anterior neck. Pyriform apices were best viewed when the trumpet manoeuvre was coupled with head turn - a manoeuvre we believe not to have been recorded in the literature previously with respect to this topic. The authors present a systematic routine for examining the upper aero-digestive tract by nasendoscope on the basis of obtaining the best view for each anatomical subsite.