Examination of the laryngopharyngeal area is not always performed during routine upper GI endoscopies.
In this study, researchers from Switzerland evaluated the positive and negative predictive value of screening the laryngopharyngeal area during routine upper GI endoscopy.
The team included all patients undergoing elective upper GI endoscopy between 2000 and 2001.
All patients underwent a careful structured examination of the laryngopharyngeal area; this was videotaped for blinded review.
If the team suspected a pathological finding, the patient was referred to an otorhinolaryngologist for further evaluation.
In all other cases the videotapes were reviewed by the otorhinolaryngologist.
The researchers performed 1311 endoscopies in 1209 patients. A total of 1191 were fully evaluated.
In 62 endoscopies a pathology in the laryngopharyngeal area was suspected. Of these, 42 were examined by the study otorhinolaryngologist.
The otorhinolaryngologist confirmed pathology in 26 patients. The team determined that this corresponded to a positive predictive value of 43% and a negative predictive value of 100%.
The team found that 1 patient had an early cancer of the pharyngeal region.
Dr Mullhaupt and colleagues concluded, "A screening examination of the laryngopharyngeal area should be part of every upper GI endoscopy".
"A serious pathology such as an early cancer may be detected in approximately 1 in 1000 endoscopies".