title: Feasibility of using the nasal route for linear endobronchial ultrasound.
abstract: OBJECTIVE
  Linear endobronchial ultrasound (EBUS) is a safe and accurate diagnostic test for mediastinal adenopathy. Its feasibility through the nasal route has not been reported. The objective of this study was to document the feasibility of linear EBUS using the nasal route and compare its accuracy and safety with the oral route.
  
  
  METHODS
  A retrospective analysis of consecutive subjects who underwent an EBUS procedure under conscious sedation at our center was conducted. Nasal insertion of the bronchoscope was attempted in all subjects; the oral route was used in case of failed nasal insertion. Characteristics of the procedure and the diagnostic accuracy of EBUS were compared between the two insertion routes.
  
  
  RESULTS
  From May to October 2012, 209 subjects underwent an EBUS. Complete data were available for 196 subjects. Nasal insertion of the EBUS bronchoscope was possible in 73.5 %. There was no difference between the two insertion routes in the location and number of stations sampled per subject. Procedure duration and complications (epistaxis, bronchial bleeding, desaturation, and pneumothorax) were similar between the two groups (2.1 % for nasal group vs 1.9 % for oral group). Minor epistaxis occurred in one subject in the nasal group. Comparing the nasal and oral groups, rates of adequate specimens were similar (90.5 vs 88.9 %, respectively; p = 0.68), and proportions of diagnostic specimens were not statistically different (51.4 vs 42.3 %, respectively; p = 0.26).
  
  
  CONCLUSIONS
  Linear EBUS can be performed safely and with high accuracy via the nasal route. Controlled studies are required to determine which insertion route provides best patient comfort.
authors.affiliation: Division of Respirology, Department of Medicine, Royal Victoria Hospital, McGill University Health Center, 687 Pine Avenue Ouest, Montreal, Qc, H3A 1A1, Canada, stephane.beaudoin@mcgill.ca.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Beaudoin
authors.forename: Nancy
authors.initials: N
authors.lastname: Ferland
authors.forename: Simon
authors.initials: S
authors.lastname: Martel
authors.forename: Antoine
authors.initials: A
authors.lastname: Delage
mesh_terms: D000368:Aged; D001999:Bronchoscopy / Q000379:methods; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016292:Procedural Sedation / Q000379:methods; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods; D019160:Endosonography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009296:Nasal Cavity; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D061214:Patient Safety; D012189:Retrospective Studies