FIBEROPTIC ENDOSCOPY

The patient has a history of T     , N     , M      squamous cell carcinoma of the
right/left      , status post definitive chemoRT, and is here today for follow-up.

Procedure: Utilizing a premedication of Exactacaine spray and 2% Lidocaine gel

applied through nasal atomizer into the right nares, the fiber optic endoscope was inserted
without difficulty. The nasal vestibule and nasal passages were carefully evaluated and
found to be within normal limits. The endoscope was advanced further and the
nasopharynx was clearly visualized. Both Eustachian orifices were clear. (A mild amount
of dried secretion was noted along the posterior pharyngeal wall.) None of this appears
to be significant, there were no abnormalities noted.

The endoscope was advanced further and hypopharnyx and base of the tongue area were
carefully evaluated and found to be      . The endoscope was then advanced into the
region of the larynx. The epiglottis was noted to be symmetrical and without lesions.
Laryngeal ventricles are completely within normal limits. Pyriform sinuses are within
normal limits. The false cords are within normal limits. The vocal cords move well and
oppose midline. The procedure was terminated without difficulty.

Impression: Clinically no evidence of disease.

Recommendation: The patient will return to my clinic in       months for routine
follow-up.