Transnasal oesophagoscopy: diagnostic and management outcomes in a prospective cohort of 257 consecutive cases and practice implications. (April 2014)

• Record Type: Journal Article
• Authors: Abou‐Nader, L.; Wilson, J.A.; Paleri, V.
• Is Part Of: Clinical otolaryngology. Volume 39:Number 2(2014:Apr.)
• Page Start: 108
• Page End: 113
• Publication Date: 2014-04
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.12241
• Languages: English
• ISSNs: 1749-4478

Abstract

<abstract abstract-type="main" id="coa12241-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="coa12241-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine the success rate, patient tolerability and impact of introducing transnasal oesophagoscopy on clinical practices.</p> </sec> <sec id="coa12241-sec-0002" sec-type="section"> <title>Design</title> <p>Prospective cohort with review of electronic patient records for outcomes.</p> </sec> <sec id="coa12241-sec-0003" sec-type="section"> <title>Setting</title> <p>UK tertiary centre Otolaryngology Department.</p> </sec> <sec id="coa12241-sec-0004" sec-type="section"> <title>Participants</title> <p>The cohort comprised of two hundred and fifty‐seven patients, 128 females (50%) and 129 males (50%) with an age range of 20–91 years; mean age 59 years (<sc>sd</sc> 13.6).</p> </sec> <sec id="coa12241-sec-0005" sec-type="section"> <title>Main outcome measures</title> <p>Success rates, indications, findings and outcomes of patients undergoing transnasal oesophagoscopy and impact on rigid examinations of the pharynx and oesophagus were also considered.</p> </sec> <sec id="coa12241-sec-0006" sec-type="section"> <title>Results</title> <p>Transnasal oesophagoscopy has a high success rate of 97%; it is well tolerated by patients, and poor views are uncommon. Pathology was detected in 44% of patients. The most common indications for transnasal oesophagoscopy were unexplained throat symptoms (50%) and dysphagia (25%). Common positive findings were hiatus hernia (7%), Barrett's oesophagus (5%), dysmotility (5%) and oesophageal candidiasis (5%). Following transnasal oesophagoscopy, 59% of patients were discharged to their referring clinician, 17% continued to undergo otolaryngology follow‐up, and 13% were referred to our gastrointestinal colleagues. Following the introduction of transnasal oesophagoscopy, there was a reduction in the number of rigid examinations of the pharynx and oesophagus in the subsequent years, despite an increase in total referrals.</p> </sec> <sec id="coa12241-sec-0007" sec-type="section"> <title>Conclusions</title> <p>Transnasal oesophagoscopy is a well‐tolerated procedure that allows otolaryngologists to make management decisions on common referrals swiftly in the clinic setting avoiding unnecessary investigations, follow‐up and referral.</p> </sec> </abstract>