Transnasal Esophageal Endoscopy: Outpatient Evaluation without Sedation
Introduction: The esophagus evaluation is fundamental in patients with dysphagia, globus, head and neck cancer, suspicion of strange body, cancer screening, and reflux. The traditional esophagoscopy is performed using large diameter endoscopies and sedation. Ultrathin transnasal endoscopy with smaller diameter allows the otorhinolaryngologists and gastroenterologists to evaluate completely the esophagus in their office without sedation, using the transnasal route.
Objective: The study aims to describe our initial experience using transnasal esophageal endoscopy (TNE) in the office, without sedation.
Methods: All 60 patients undergoing a TNE were enrolled in a prospective case series study. All examinations were performed in conjunction by the otorhinolaryngologist and gastroenterologist. The patient is seated in a standard ENT examining chair and both sides of the nose is topically anesthetized and vasoconstricted. Additional topical anesthetic spray is used in the oropharynx. The endoscope (EE 1580 K 5, 1-mm Pentax) is passed into the nasal and cavity gently advanced into the gastric cardia for a view of the gastroesophageal junction (GEJ).
Results: A total of 52 patients completed the exam. Among the patients who did not complete the examination, five presented important nasal obstructions and three patients showed intense gag reflex. Nasal pain was absent or mild in most patients.
Conclusion: The transnasal esophageal endoscopy is an important tool for diagnosis of esophageal disease. It is perfectly feasible and safe to be performed in the office and is well accepted by the majority of patients.