Transnasal esophagoscopy: a high-yield diagnostic tool.
OBJECTIVE
Transnasal esophagoscopy (TNE) reveals a wide range of esophageal findings. TNE technique, indications, outcomes, advantages, limitations, and impact on patient care are described.


METHODS
Retrospective chart review.


METHODS
Charts of the first 30 patients to undergo TNE in an academic otolaryngology practice were reviewed. Technique details, patient demographics, and procedure indications and findings as well as the disposition of patients in this series are described. TNE limitations are discussed with areas for future development.


RESULTS
Thirty patients who underwent unsedated outpatient TNE by their otolaryngologist are described. TNE was directed toward select indications: dysphagia, screening esophagoscopy given long-standing gastroesophageal reflux (GER) or laryngopharyngeal reflux (LPR), and esophageal surveillance with a new diagnosis of head and neck squamous cell carcinoma. Positive findings included mucosal cobblestoning, Barrett's esophagus, esophagitis, gastritis, candidal esophagitis, esophageal diverticulum, postcricoid mass, patulous esophagus, and absence of secondary esophageal peristalsis. Outcomes included referral to a gastroenterologist for evaluation, with or without biopsy; direct laryngoscopy or esophagoscopy with biopsy by the otolaryngologist; planned cancer resection by the otolaryngologist; and medical management of GER/LPR by the otolaryngologist.


CONCLUSIONS
With appropriate selection criteria, TNE yields a high percentage of positive findings and wide range of esophageal abnormalities, directly impacting patient management. Available to otolaryngologists in the outpatient setting, TNE expedites interventions by providing a safe, effective alternative to rigid esophagoscopy under general anesthesia and flexible upper endoscopy with sedation. Patients will benefit from the integration of TNE into otolaryngologists' outpatient diagnostic armamentarium.
Andrus
Jennifer G
JG
Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts 01805, USA.
Dolan
Robert W
RW
Anderson
Timothy D
TD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001471:Barrett Esophagus / Q000473:pathology; D002177:Candidiasis / Q000473:pathology; D003680:Deglutition Disorders / Q000473:pathology; D004936:Diverticulum, Esophageal / Q000473:pathology; D004941:Esophagitis / Q000473:pathology; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005764:Gastroesophageal Reflux / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose; D012189:Retrospective Studies