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In performing an esophagoscopy, nothing can be so disconcerting as a persistently contracted cricopharyngeus muscle. Not only the novice, but occasionally even the more experienced operator, meets cases in which, despite preliminary morphinization and properly applied cocainization, the tightly constricted entrance to the esophagus (due to a highly developed or unduly contracted cricopharyngeus muscle), if not impossible to pass, is provocative of great distress to the patient and embarrassment to the esophagoscopist.
Cases are encountered, fortunately seldom, in which general narcosis is necessary to produce sufficient relaxation of the cricopharyngeus before the esophagoscope can be introduced.
As particularly emphasized by Chevalier Jackson, undue force in introducing the esophagoscope is dangerous; serious damage to the tissues, and even fatal perforation may ensue. The most difficult phase of the procedure is the passage of the tube past the cricopharyngeus muscle. As Jackson also properly advocates, blind bouginage or passage
MANDELBAUM MJ. AN EASIER METHOD OF INTRODUCING THE ESOPHAGOSCOPE. Arch Otolaryngol. 1926;4(4):307–309. doi:10.1001/archotol.1926.00590010329006
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