A new technique to expose the hypopharyngeal space: The Modified Killian's method

A new technique to expose the hypopharyngeal space: The Modified Killian's method
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DOI:
10.1016/j.anl.2013.10.012
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发表时间:
2014-04-01
期刊:
影响因子:
1.7
通讯作者:
Iida, Masahiro
Iida, Masahiro
中科院分区:
医学3区
文献类型:
--
作者:
Sakai, Akihiro;Okami, Kenji;Iida, Masahiro

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目的:最近内窥镜技术的显著进步使过去无法发现的浅表性癌症得以检测。然而,即使先进的内窥镜技术可以发现早期病变,但除非它能提供一个区域的广泛暴露,否则它是无用的。通过修改Killian位置,可以观察到比传统头部位置更大范围的下咽空间。我们报告了一种革命性的方法,使用一个新的头部位置来广泛打开下咽。这项技术被命名为“改良基利安法”。方法:患者最初被放置在基利安姿势,然后从原始姿势(即改良基利安姿势)进一步向前弯曲。在这个姿势中,病人转过头,应用瓦尔萨尔瓦手法。结果:常规头位不能充分打开下咽间隙,而改良Killian‘s法下咽间隙开得很宽。结论:改良Killian’s法可观察下咽间隙及颈段食道进路的周长。改良的Killian‘s法可能成为观察下咽和发现下咽癌不可缺少的技术。(C)2013爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: Recent remarkable progress in endoscopic technology has enabled the detection of superficial cancers that were undetectable in the past. However, even though advanced endoscopic technology can detect early lesions, it is useless unless it can provide wide exposure of an area. By modifying the Killian position, it is possible to observe a wider range of the hypopharyngeal space than is possible with conventional head positions. We report a revolutionary method that uses a new head position to widely open the hypopharynx. The technique is named "the Modified Killian's method."Methods: The patient is initially placed in the Killian position and then bent further forward from the original position (i.e., the modified Killian position). While in this position, the patient's head is turned and the Valsalva maneuver is applied. These additional maneuvers constitute the Modified Killian's method and widely expands the hypopharyngeal space.Results: The conventional head position cannot open the hypopharyngeal space sufficiently; however, the Modified Killian's method opens the hypopharyngeal space very widely.Conclusion: The Modified Killian's method enables observation of the entire circumference of the hypopharyngeal space and the cervical esophageal entry. The Modified Killian's method may become an indispensable technique for observing the hypopharynx and detecting hypopharyngeal cancers. (C) 2013 Elsevier Ireland Ltd. All rights reserved.