TransNasal / UltraThin / Unsedated Esophagoscopy
Who is a candidate for transnasal esophagoscopy (TNE)?
Candidates for TNE are:
- Individuals with heartburn that doesn't respond to antacid medication and dietary changes
- Individuals with laryngopharyngeal reflux symptoms that don't respond to antacid medication and dietary changes. This includes sensation of something stuck in the throat, and an acid or bitter taste in the back of the throat
- Individuals with chronic cough without an identified cause
- Individuals with a lump in the throat sensation (globus pharyngeus)
- Individuals with hoarseness and lowered pitch of the voice may also be candidates
What is involved in transnasal esophagoscopy?
TNE takes less than 30 minutes and can be done during a scheduled office visit. It can also be scheduled as a separate short procedure. The procedure is performed in the office without sedation. Patients can drive themselves home and wear standard street clothing. Patients sit in a standard examination chair in the examination room. Topical anesthesia (lidocaine) and decongestion (Afrin) are applied to one of the nasal passages. A small amount of lidocaine liquid can be used to help numb the throat and esophagus. A flexible endoscope (camera) is then passed through one of the nasal passages into the throat and down into the esophagus. Air is puffed into the esophagus and stomach, which can cause some burping.
Individuals can experience discomfort in the nose, the throat and the stomach, which stops when the endoscope is removed. Some individuals might feel lightheaded. The camera is then advanced to the end of the esophagus and into the stomach. Video images are taken during the examination to review with the patient at the end of the visit. We do recommend that you not eat approximately 2 hours before this procedure.
What can I expect after transnasal esophagoscopy?
Patients will have a numb throat for 45 minutes to an hour after the procedure. They should not have anything to eat or drink for one hour after the procedure to make sure they don't aspirate (have food or liquid go down "the wrong pipe"). The nose can sometimes be a little sore after the procedure. Taking Tylenol should be sufficient to control any discomfort related to this.
Why should I have transnasal esophagoscopy at the Chicago Institute for Voice Care?
Dr. Sims, laryngologist and voice doctor, has specialized training in disorders of the larynx, trachea and esophagus. He has extensive experience with TNE and other office procedures and uses multiple relaxation techniques to make the procedure as fast, effective and comfortable as possible.
Having these procedures in the office permits a laryngologist to obtain important information about the esophagus in a safe and effective way. Importantly, performing TNE in this manner prevents an evaluation with sedation. Sedation can carry additional risk, such as blood pressure changes, lightheadedness and even heart attack and stroke. Also, sedation requires time off of work and the need for others to devote time to caretaking after the procedure.
If we see something that needs to be followed, we are happy to refer you to a gastroenterologist if you choose. We can also arrange your follow-up in our office. We will make every effort to communicate any important findings to your other care providers unless you specifically request that we do not share information.