Role of transnasal flexible laryngo-oesophagoscopy (TNFLO) in investigating patients with globus symptoms.
OBJECTIVE
To explore the rationale for investigating patients presenting with globus symptoms. In this regard, we also assess the efficacy and safety of transnasal flexible laryngo-oesophagoscopy (TNFLO).


METHODS
A prospective study in a head and neck cancer centre of patients with persistent globus symptoms with normal flexible nasoendoscopy/indirect mirror laryngoscopy and failure of first-line medical treatment. The role of TNFLO in investigating these patients was assessed.


RESULTS
A total of 218 patients were recruited in this study. Positive findings included upper aerodigestive cancers in two patients, other pathologies included reflux (four patients), cricopharyngeus-related pathologies (19 patients), candida (five patients). There were only five re-referrals of patients who were discharged following normal examination with TNFLO. In nine patients, TNFLO could not be completed and they went on to have other diagnostic procedures CONCLUSION: This article is the largest to date in the UK to assess the role of TNFLO in investigating patients with globus symptoms. TNFLO is equal to rigid endoscopy as a diagnostic tool. However, it is superior in terms of image clarity, ability to record video images and safety.
Department of Otolaryngology-Head and Neck Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
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http://orcid.org/0000-0003-0918-6430
H
Mohammed
Department of Otolaryngology-Head and Neck Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
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M
Coates
Department of Otolaryngology-Head and Neck Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
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L
Masterson
Department of Otolaryngology-Head and Neck Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
W Y
WY
Chan
Department of Otolaryngology-Head and Neck Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
Y
Y
Hassan
Department of Otolaryngology-Head and Neck Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
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R
Nassif
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D011446:Prospective Studies; D006113:United Kingdom; D055815:Young Adult
diagnosis; dysphagia; endoscopy; gastro-oesophageal; head and neck cancer; infectiuous conditions; reflux