Role of Flexible Laryngoscopy Using Modified Killian’s Method in the Evaluation of Hypopharyngeal and Laryngeal Cancers

Priyanka, Schilling Amar (2019) Role of Flexible Laryngoscopy Using Modified Killian’s Method in the Evaluation of Hypopharyngeal and Laryngeal Cancers. Masters thesis, Christian Medical College, Vellore.


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INTRODUCTION: Flexible laryngoscopy is an important outpatient diagnostic procedure in the evaluation of hypopharyngeal and laryngeal cancers especially for their staging and mapping of their mucosal extent. The Modified Killian’s technique is one of the described adjunct techniques used during flexible laryngoscopy to improve its accuracy and increase visualization. OBJECTIVES: 1. To improve the visualization of the hypopharynx and increase the accuracy of flexible laryngoscopy by modified Killian’s method. 2. To compare the staging and extent of laryngeal and hypopharyngeal cancers between Flexible laryngoscopy using modified Killian’s method and routine flexible laryngoscopy. Secondary objective: To compare Modified Killian’s Method with Direct Laryngoscopy in evaluation of hypopharyngeal cancers. METHODS: A total of 50 consecutive patients with suspected hypopharyngeal and laryngeal malignancy who presented to the ENT outpatient department underwent flexible laryngoscopy by the conventional method and Modified Killian’s method. The site and extent of tumour was graded using Murono’s scale from 1 to 5. A subset of these patients who underwent direct laryngoscopy under general anaesthesia were also scored with the above scale. The scores were compared to check the accuracy of flexible laryngoscopy with the modified Killian’s method in staging the cancer. RESULTS: In the study, it was found that the Modified Killian’s method technique during flexible laryngoscopy showed highly significant improvement in the Murono score of grading of the extent of hypopharyngeal and laryngeal tumours as compared to the normal method of laryngoscopy. In addition, the subset analysis demonstrated a significant agreement between direct laryngoscopy and Modified Killian’s method. CONCLUSION: The Modified Killian’s method is therefore, a good diagnostic tests and a valuable adjunct to diagnostic flexible laryngoscopy in the office evaluation and staging of hypopharyngeal and laryngeal cancers. It increases the accuracy of flexible laryngoscopy in the visualization of the hidden areas of larynx and hypopharynx and aids in the early diagnosis of patients with suspected malignancy. Hence, we suggest that Modified Killian’s method should be a part of the routine endoscopic evaluation of suspected laryngeal and hypopharyngeal cancers in the outpatient department.

Item Type: Thesis (Masters)
Additional Information: Reg.No.221614354
Uncontrolled Keywords: Hypopharyngeal and laryngeal cancers, diagnostic flexible laryngoscopy, Modified Killian’s method, Murono’s scale, direct laryngoscopy.
Subjects: MEDICAL > Otolaryngology
Depositing User: Subramani R
Date Deposited: 31 Aug 2019 23:50
Last Modified: 01 Sep 2019 01:51

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