title: Utility and stability of transnasal endoscopy for examination of the pharynx - a prospective study and comparison with transoral endoscopy.
abstract: OBJECTIVE
  Transnasal endoscopy may be used to observe the head and neck part readily without excessive reflexes. We aimed to evaluate the utility and stability of transnasal esophagogastroduodenoscopy (TN-EGD) in comparison with transoral EGD (TO-EGD) for observation of the pharynx.
  
  
  METHODS
  Prospective study
  
  
  METHODS
  A total of 497 patients received unsedated TN-EGD with a 5.5 mm diameter endoscope or unsedated TO-EGD with endoscopes of 6.5 mm, 7.9 mm and 9.2 mm diameter. The rate of completion of pharyngeal observation and numbers of gag reflexes and cough reflexes were recorded.
  
  
  RESULTS
  TN-EGD was performed in 175 patients and TO-EGD was performed in 322 patients. Pharyngeal observation was completed in 173 patients (98.9%) in the TN-EGD group and 235 patients (73.2%) in the TO-EGD group, a significant difference (p<0.001). The TN-EGD group had a low rate of occurrence of gag reflex (0.57%), in contrast, 28.3% of the TO-EGD group had a gag reflex, a significant difference (p<0.01). Multivariable analyses revealed that the use of TN-EGD was the only predictive factor for completion of pharyngeal observation (p<0.0001).
  
  
  CONCLUSIONS
  TN-EGD is ideally suited to observation of the pharynx by unsedated EGD.
authors.affiliation: Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Tsuboi
authors.forename: Makoto
authors.initials: M
authors.lastname: Arai
authors.forename: Daisuke
authors.initials: D
authors.lastname: Maruoka
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Matsumura
authors.forename: Tomoo
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Katsuno
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010614:Pharynx / Q000473:pathology*; D011446:Prospective Studies
keywords: Cancer.; Pharynx; Transnasal EGD; Transoral EGD