Endoscopic Diagnosis and Treatment of Superficial Cancer in the Oropharynx and Hypopharynx

Abstract

Although early detection of oropharyngeal and hypopharyngeal cancer has been rather difficult, narrow-band imaging (NBI) technology makes it possible. NBI is an innovative optical technology that can clearly visualize the microvascular structure of the organ surface when it is combined with magnifying endoscopy. This breakthrough opened a brand-new door of endoscopic diagnosis, not only of head and neck cancer but also of other gastrointestinal tract cancer. This new diagnostic strategy is based on microvascular morphological changes in the organ surface. Superficial squamous cell carcinoma of the oropharynx and hypopharynx shows typical characteristics. A well-demarcated brownish area and scattered irregular foci of microvascular proliferation projecting to the dysplastic squamous epithelium are the typical endoscopic features of the lesions. The number of detections of superficial cancer has increased over the past few years. For these superficial cancers, endoscopic treatment, generally accepted as a standard treatment for early cancer in the gastrointestinal field, is applied as a minimally invasive treatment. The endoscopic mucosal resection (EMR) cap method, endoscopic subepithelial dissection method, or endoscopic laryngopharyngeal surgery is performed under general anesthesia. Collaboration with otorhinolaryngologists and anesthesiologists is very important to successfully perform EMR in this region. This field also has problems directly linked to quality of life, such as swallowing and utterance. The establishment of early detection and of less invasive treatment is anticipated to provide great benefit to the patients.