Is esophagoscopy necessary during panendoscopy?

BACKGROUND Panendoscopy, or the evaluation of the upper aerodigestive tract with oral inspection, direct laryngoscopy, esophagoscopy, bronchoscopy, or some combination of these procedures, is a valuable tool in the evaluation of patients with head and neck squamous cell carcinoma (HNSCC). Despite the many advances made in imaging technology in recent years, these modalities cannot replace the surgeon’s ability to carefully inspect the mucosa of the upper aerodigestive tract to determine the true extent of a lesion and plan for possible surgical resection. Second primary malignancies are also a concern in HNSCC patients; historically, esophagoscopy during panendoscopy has been recommended to rule out esophageal carcinomas. However, this procedure can at times be difficult and also carries the potential for serious complications such as esophageal perforation. Thus, this article reviews the evidence for the utility of esophagoscopy in the diagnostic evaluation of the head and neck cancer patient.