Transnasal esophagoscopy: Revisited (over 700 consecutive cases)

Background: High-resolution transnasal esophagoscopy (TNE) allows comprehensive, in-office examination of the esophagus without sedation. Objective: To compare the authors' present experience using TNE with our initial, previously reported experience. Methodology: Retrospective review of 611 consecutive patients undergoing TNE was compared with 100 consecutive patients previously reported. Results: The most frequent indications for TNE were screening examination of the esophagus in reflux, globus, or dysphagia patients (n = 490), biopsy of a lesion in the laryngopharynx, trachea, or esophagus (n = 42), screening examination of the esophagus in head and neck cancer patients (n = 45), and evaluation for an esophageal foreign body (n = 12). Seventeen procedures were aborted secondary to a tight nasal vault. Significant findings were found in 50% (294/592). The most frequent findings were esophagitis (n = 98), hiatal hernia (n = 47), and Barrett's esophagus (n = 27). These results are similar to those previously reported. Conclusions: TNE is safe, well tolerated by patients, and is easy to learn with a short learning curve. TNE may replace radiographic imaging of the esophagus in otolaryngology patients with reflux, globus, and dysphagia.