This article is a report by Silberman on his initial experience with a disposable, single-use EndoSheath® Technology (EndoSheath® Technology with ENT Scope, Vision-Sciences, Natick, MA) to provide sterility during flexible nasopharyngolaryngoscopy. For 50 procedures, the author recorded one of five ratings (poor, below average, average, above average, or excellent) for nine variables associated with use of the system (image clarity, illumination, uniformity of illumination, lack of fogging, ease of passage and feel of the endoscope, flexibility of endoscope during procedure, ease of distal tip angulation, ease of sheath placement and removal, and overall impression).
The most common rating in the series was excellent, which was assigned for one or more of the nine evaluated characteristics in 29 to 40 of the 50 procedures, including 36 procedures in which overall impression received an excellent rating. The second most common rating was above average. A poor or below-average rating was assigned only eight times, primarily for difficulty in removing the EndoSheath® Technology, which the author noted was caused by his mishandling of the device. The two instances of difficulty in passing the endoscope occurred in patients who had extremely dry mucosa because of systemic disease or radiation therapy. There were no ruptures of any disposable sheaths in the series.
Silberman commented that the EndoSheath® system has excellent optical qualities, with no degradation of the image, and avoids the need for high-level disinfection or sterilization of a nasopharyngolaryngoscope between uses. According to the author, the disadvantages of high-level disinfection or sterilization include damage to the endoscope over time; the risk of contamination because of inadequate disinfection practices; the potential for allergic reactions in health care personnel exposed to glutaraldehyde during endoscope reprocessing; and the considerable time required, which may necessitate the purchase of several nasopharyngolaryngoscopes in order to provide continuous service.
Silberman concluded that the EndoSheath® Technology worked extremely well in his patients, with no adverse effects on diagnostic variables. He recommended the system as the simplest method of obtaining true sterilization of nasopharyngolaryngoscopes.