All endoscopic procedures were carried out using a magnifying endoscope (GIF-H260Z; Olympus Medical Systems, Tokyo, Japan) with a hood attachment (MAJ-1990; Olympus Medical Systems). The videoendoscopy system used in this study comprised a video processor (EVIS LUCERA ELITE CV-290; Olympus Medical Systems) and a light source (EVIS LUCERA ELITE CLV-290SL; Olympus Medical Systems). Prior to the procedure, each patient was given 100 mL water containing 20,000 units pronase (Kaken Pharmaceutical, Tokyo, Japan), 1 g sodium bicarbonate, and 10 mL dimethylpolysiloxane (20 mg/mL; Horii Pharmaceutical Industries, Osaka, Japan).
Afterward, pharyngeal anesthesia was performed as described in “Study design and anesthesia protocols.”
Patients were placed in the left lateral decubitus position, with endoscopic examinations carried out while they were awake or under conscious sedation with midazolam (Dormicum Injection; Astellas Pharma, Tokyo, Japan). The patient's wish to the use of a sedative was obtained before the procedure. The sedative was adjusted within the range of 2 mg to 5 mg based on the patient's body weight. The pharynx was assessed at the beginning of each examination, and standard endoscopy was carried out at the end of each pharyngeal examination. If pharyngeal lesions were detected, the examination was completed first and the lesions were evaluated at the end of endoscopy.
Afterward, pharyngeal anesthesia was performed as described in “Study design and anesthesia protocols.”
Patients were placed in the left lateral decubitus position, with endoscopic examinations carried out while they were awake or under conscious sedation with midazolam (Dormicum Injection; Astellas Pharma, Tokyo, Japan). The patient's wish to the use of a sedative was obtained before the procedure. The sedative was adjusted within the range of 2 mg to 5 mg based on the patient's body weight. The pharynx was assessed at the beginning of each examination, and standard endoscopy was carried out at the end of each pharyngeal examination. If pharyngeal lesions were detected, the examination was completed first and the lesions were evaluated at the end of endoscopy.