Flexible Endoscopy (FE)
Flexible endoscope with an out-diameter of 2.6 mm and working length of
30 cm (ENF-V3, Olympus) was introduced via patient’s nose (left) and
advanced to aeroesophageal tracks for inspection. Nose-closure maneuver
with SPI duration of 2-5 seconds was performed to gradually expand the
associated lumens in order to facilitate a complete and dynamic
evaluation. FE assessed the structures in following order: pharynx,
larynx, trachea, TEF, bilateral bronchi, lower esophagus, stomach, then
withdrew back to pharynx and went to upper esophagus. Commonly
associated anatomic anomalies such as TM, fistula and upper esophageal
pouch were clearly identified. The fistula location and opening width
were estimated with FE. The distance from the upper edge of the carina
to the lower edge of fistula was measured using the FE tip technique.