Abstract
Multiple primary carcinomas may occur in the contiguous pathways of the upper aerodigestive tree, particularly in those patients who smoke tobacco or drink alcohol.1,2 As a result, panendoscopy is frequently carried out in staging patients with head and neck tumors. Although the percentage of simultaneous second primary cancers is low (2.5% to 8%),3-5 it is felt that a full assessment of the upper aerodigestive tract is necessary to accurately define the prognosis and to initiate early therapeutic measures in an attempt to maximize patient survival. In our institution, the head and neck surgeons routinely perform esophagoscopy as a staging procedure prior to head and neck cancer surgery. We were recently asked to provide the surgeons with preoperative esophagoscopy in a patient with squamous cell carcinoma of the left tonsillar fossa. Because severe trismus secondary to local extension of the tumor precluded a standard oropharyngeal intubation, a nasopharyngeal approach was used.
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