The Practicability of Transnasal Esophagoscopy and the Evaluation of Patient’s Perception: A Prospective Study

Abstract

ObjectivesTransnasal esophagoscopy (TNE) is a relatively new diagnostic procedure in the evaluation of patients with globus sensation and dysphagia. Enabling doctors to examine all of the upper aerodigestive system without the need for sedation, this technique is becoming more popular among otolaryngology specialists. The aim of this study is to evaluate the practicability of TNE and tolerability of patients to the test.MethodsThe study group consisted of 314 patients who were admitted to the swallowing center of a tertiary medical institution with the symptoms of dysphagia and globus sensation. In addition to other diagnostic procedures, patients were informed of the TNE and the necessary consents were obtained. Before the examination, patients were asked to foresee the level of discomfort they would presumably feel, according to the information they had. After the TNE, patients were asked to score the real level of discomfort they experienced during the test. A visual analog scale was used to note the levels. The duration of the tests and any complications were also noted.ResultsWe could not perform TNE in 12 of the 314 patients due to nasal obstruction, intractable retching and vasovagal syncope (7, 4, and 1 patients, respectively). The average discomfort score foreseen before the test was 4.7±1.4 (mean±standard deviation). The post-procedure discomfort score was 1.6±1.1, and the difference was statistically significant (P<0.001). The average time to perform the TNE was 5 minutes (range, 3 to 13 minutes). Except for minor epistaxis in 7 patients (2%), no complications occurred.ConclusionAccording to our results, TNE is an easy and well-tolerated procedure, it may be logical to tell the patient that the procedure will be less annoying and irritating than they assume. It is also a time saving procedure with low complication rates.

Prevalence of Synchronous ESCN in Head and Neck Cancer: A Single‐Institution Perspective

“…TOE especially if performed under sedation, increases the risk of cardiopulmonary events in elderly patients with comorbidities and thus requires careful monitoring and nursing care 30,31 . On the contrary, unsedated trans‐nasal esophagoscopy using ultra‐thin esophagoscope is a safe, feasible, and well‐tolerated procedure that can be performed under local anesthesia without sedation in sitting position by ENT–Head and Neck Clinicians as an office‐based procedure in their clinic for early detection of synchronous ESCN and our study also confirmed these findings 32,33 . In our study, the procedure was abandoned due to bleeding from the proliferative primary tumors in seven patients, which stopped spontaneously without any interventions and complete cricopharyngeal luminal obstruction in four patients, and thus 96.5% patients completed the examination.…”

Endoscopic meatus scoring scale versus sniff test to predict insertability before transnasal endoscopy: A prospective, randomized study

“…Insertion failure (median 5.8%, range 0–22%), epistaxis (median 2.7%, range 0–33%), and nasal pain (median 35%, range 0–58.3%) associated with UT‐EGD have been reported in the literature, but their ranges are too wide, so is the median visual analogue scale (VAS, 0–5) for nasal pain (1.4 ± 0.4, range 0.8–1.9) . In contrast, the average nasal pain (2.5 ± 0.8, range 1.2–3.7), insertion failure (3.1%, range 0–10.9%), and epistaxis (4.7%, range 0–8.9%) are more convergent and thus reliable to reflect the real‐world data from my study seriers . In brief, the approximately average side effect triad nasal pain (~VAS 2), insertion failure (~3%), and epistaxis (~4%) are tempting for inexperienced endoscopists and patients to accept UT‐EGD.…”