Categories: INTRODUCTION OF THE ESOPHAGOSCOPE
Sources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Recumbent patient. Boyce
position. The larynx is to be exposed as in direct laryngoscopy, the
right pyriform sinus identified, the tip of the speculum inserted
therein, and gently insinuated to the cricopharyngeal constriction.
Too great extension of the head is to be avoided--even slight flexion
at the occipito-atloid joint may be found useful at times. Moderate
anterior or upward traction pulls the cricoid away from the posterior
pharyngeal wall and the lumen of the esophagus opens above a
crescentic fold (the cricopharyngeus). The speculum readily slides
over this fold and enters the cervical esophagus. In searching for
foreign bodies in the esophagus the speculum has the disadvantage of
limited length, so that should the foreign body move downward it could
not be followed.