Transnasal esophagoscopy (TNE) is a safe and inexpensive way to examine the

esophagus The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...

in patients at risk for

esophageal cancer Esophageal cancer is cancer arising from the esophagus—the food pipe that runs between the throat and the stomach. Symptoms often include difficulty in swallowing and weight loss. Other symptoms may include pain when swallowing, a hoarse voice ...

and other disorders. TNE doesn't require sedation, unlike other techniques widely used to look into the esophagus. This is possible because TNE uses a camera that is passed through the nose, whereas other techniques, such as upper endoscopy, are performed through the mouth, requiring a patient to be sedated. TNE, as it is used today, was developed by Jonathan E. Aviv who published his findings on the first series of TNE that he performed. The origins of the idea to pass the camera through the nose date from 1993 as first described by C. A. Prescott, MD, a pediatrician

otolaryngologist Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical a ...

in Cape Town, South Africa and further embellished by Reza Shaker, MD, a

gastroenterologist Gastroenterology (from the Greek gastḗr- “belly”, -énteron “intestine”, and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, ...

in Milwaukee, WI in 1994. However, it wasn't until the year 2000 when Jonathan E. Aviv, MD, published his findings on the first series of TNE he performed, that it began to have a widespread attention by ear, nose, and throat doctors. Since that time it has been used by both otolaryngologists and gastroenterologists as a diagnostic tool to detect globus,

dysphagia Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a disease#Terminology, condition in its own right. It may be a sensation that suggests difficulty in the passag ...

laryngopharyngeal reflux Laryngopharyngeal reflux (LPR) is the retrograde flow of gastric contents into the larynx, oropharynx and/or the nasopharynx. LPR causes respiratory symptoms such as cough and wheezing and is often associated with head and neck complaints such as ...

(LPR), gastroesophageal reflux disease (

GERD Gerd or GERD may refer to: * Gerd (given name), a list of people with the given name or nickname * Gerd (moon), a moon of Saturn * Gerd Island, South Orkney Islands, Antarctica * Gastroesophageal reflux disease, a chronic symptom of mucosal damage ...

). TNE may also be useful in detecting Barrett's, but there is incongruence between TNE findings and biopsy results. Experts in the field suggest that TNE may replace radiographic imaging of the esophagus in otolaryngology patients with reflux, globus, and dysphagia.

Technique

Transnasal esophagoscopy is an office based procedure in which the patient is anesthetized locally in the nose and sometimes the

oropharynx The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and trachea (the tubes going down to the stomach and the lungs). It is found in vertebrates and invertebrates, though its struct ...

. The scope is advanced into the

ipsilateral Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...

pyriform sinus On either side of the laryngeal orifice in humans is a recess, termed the pyriform sinus (also piriform recess, piriform sinus, piriform fossa, or smuggler's fossa), which is bounded medially by the aryepiglottic fold, laterally by the thyroid car ...

and through the esophageal inlet to the stomach, where the esophagus can be examined, with special attention paid to the gastroesophageal (GE) junction. An advantage of TNE over other more invasive cancer screening methods that require

conscious sedation Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decr ...

is that it can be performed using topical anesthesia alone with the patient sitting upright in an exam chair unencumbered by cardiac monitoring equipment.Belafsky PC, Postma GN, Daniel E, Koufman JA (2001). "Transnasal esophagoscopy". Otolaryngology–Head and Neck Surgery 15 (1): 588–589.

References

{{reflist Otorhinolaryngology