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Swallowing disorders can now be assessed in the office with trans-nasal oesophagoscopy without sedation

There has been a large trend away from endoscopy suites to in-office endoscopy for the evaluation of swallowing disorders.  The advances in endoscope technology have enabled very narrow diametre scopes with exceptional digital camera quality to be used in performing office-based, unsedated transnasal oespohagoscopy in evaluating swallowing disorders. This technology now exists in Brisbane and Dr Matthew Broadhurst performs these procedures in his office. Because there is no sedation required, patients can drive themselves to and from appointments. Below is a typical image from trans-nasal oesophagoscopy performed in a patient with dysphagia.

 

 

 

An injection of Restylane done in Dr Broadhurst’s rooms can give a significant improvement in the voice as a temporary measure for a vocal cord paralysis. The effect lasts 3 months and can be repeated while waiting to see if the nerve to the vocal cord will recover. In the meantime, it gives patients a near normal voice while they are waiting. The lesion during suspension after KTP laser treatment of the cancer, the remainder of the right vocal cord is seen, totally preserved. There is no collateral heat damage, unlike with other lasers, so voice outcomes are superior.

 

 

 

 

The glass fibre from the pulsed KTP laser is seen treating the cancer. Laryngeal forceps are used to steady the lesion during suspension microlaryngoscopy treatment. There is maximal preservation of non-cancerous tissue, which has previously not been possible.

 

 

During suspension microlaryngoscopy, a small right vocal cord cancer is seen. The patient has severe dysphonia but will regain a normal voice following careful treatment with a pulsed KTP laser.

The KTP laser is also ideally suited to vascular lesions of the vocal cords that occur in singers and other professional voice users. Voices can be totally restored with this advanced technology.