Transnasal Esophagoscopy—Our Experience
22. Januar 2018
06. Mai 2018
11. Oktober 2018 (online)
Introduction Transnasal esophagoscopy (TNE) is a widely used tool both in the diagnosis and treatment of patients presenting complaints within the head and the neck. This is because this investigative adjunct examination provides the advantage of visualizing above the level of the cricopharyngeus muscle when compared to the more widely used esophagogastroduodenoscopy (EGD).
Objectives We have assessed if the implementation of TNE within a district general hospital (DGH) was feasible, and investigated if the resources of our patients could be better directed away from other investigations such as barium swallow and EGD in favor of this novel technique. The TNE technique has been largely applied in central teaching hospitals within the United Kingdom, but there are still no published reports of a DGH investigating its applicability in this smaller-sized clinical environment.
Method We have analyzed our theater database to find all the patients who had undergone TNE, and recorded their reason for presenting, the preceding investigations, and the procedural findings.
Results In most cases, the TNE was conducted without technical issues, and we were able to identify positive findings in 43% of the patients who underwent Esophagogastroduodenoscopy (EGD). We were able to treat patients successfully during the investigation when a cricopharyngeal stricture or narrowing was found. A normal EGD did not preclude further investigations with TNE. All but one of our patients were treated as day-case procedures.
Conclusion Transnasal esophagoscopy can be successfully delivered within a DGH. A previous EGD does not mean that the TNE will not reveal positive findings due to its superior visualization of the pharynx and the upper esophagus.
- 1 McPartlin DW, Nouraei SA, Tatla T, Howard DJ, Sandhu GS. How we do it: transnasal fibreoptic oesophagoscopy. Clin Otolaryngol 2005; 30 (06) 547-550
- 2 Aviv JE, Takoudes TG, Ma G, Close LG. Office-based esophagoscopy: a preliminary report. Otolaryngol Head Neck Surg 2001; 125 (03) 170-175
- 3 Sabirin J, Abd Rahman M, Rajan P. Changing trends in oesophageal endoscopy: a systematic review of transnasal oesophagoscopy. ISRN Otolaryngol 2013; 2013: 586973
- 4 Price T, Sharma A, Snelling J. , et al. How we do it: The role of trans-nasal flexible laryngo-oesophagoscopy (TNFLO) in ENT: one year's experience in a head and neck orientated practice in the UK. Clin Otolaryngol 2005; 30 (06) 551-556
- 5 Peery AF, Hoppo T, Garman KS. , et al; Barrett's Esophagus Risk Consortium. Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video). Gastrointest Endosc 2012; 75 (05) 945-953.e2
- 6 Britt CJ, Lippert D, Kammer R. , et al. Secondary tracheoesophageal puncture in-office using Seldinger technique. Otolaryngol Head Neck Surg 2014; 150 (05) 808-812
- 7 Fukuhara T, Fujiwara K, Nomura K, Miyake N, Kitano H. New method for in-office secondary voice prosthesis insertion under local anesthesia by reverse puncture from esophageal lumen. Ann Otol Rhinol Laryngol 2013; 122 (03) 163-168
- 8 Belafsky PC, Postma GN, Daniel E, Koufman JA. Transnasal esophagoscopy. Otolaryngol Head Neck Surg 2001; 125 (06) 588-589