Transnasal Esophagoscopy

BACKGROUND: Transnasal esophagoscopy (TNE), a new diagnostic technology, allows comprehensive, in-office examination of the esophagus without sedation. OBJECTIVE: To report the authors' experience using TNE. METHODOLOGY: Retrospective review of 100 consecutive patients undergoing TNE. RESULTS: The most frequent indications for TNE were screening examination of the esophagus in reflux, globus, and/or dysphagia patients (n = 79), biopsy of a lesion in the laryngopharynx, trachea, or esophagus (n = 8), screening examination of the esophagus in head and neck cancer patients (n = 5), tracheoscopy and bronchoscopy (n = 4), and evaluation for an esophageal foreign body (n = 2). Four procedures were aborted secondary to a tight nasal vault. Significant findings were found in 44% (42/96). The most frequent findings were esophagitis (n = 19), Barrett's (n = 6), hiatal hernia (n = 4), and carcinoma (n = 5). CONCLUSIONS: TNE is safe and well tolerated by patients with topical anesthesia alone. TNE may replace radiographic imaging of the esophagus in otolaryngology patients with reflux, globus, and dysphagia.