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. 2013 Jul 3;10(9):1085-91.
doi: 10.7150/ijms.6003. Print 2013.

Utility and stability of transnasal endoscopy for examination of the pharynx - a prospective study and comparison with transoral endoscopy

Masaru Tsuboi  1 , Makoto Arai, Daisuke Maruoka, Tomoaki Matsumura, Tomoo Nakagawa, Tatsuro Katsuno, Osamu Yokosuka
Affiliations

Utility and stability of transnasal endoscopy for examination of the pharynx - a prospective study and comparison with transoral endoscopy

Masaru Tsuboi et al. Int J Med Sci. .

Abstract

Objective: Transnasal endoscopy may be used to observe the head and neck part readily without excessive reflexes. We aimed to evaluate the utility and stability of transnasal esophagogastroduodenoscopy (TN-EGD) in comparison with transoral EGD (TO-EGD) for observation of the pharynx.

Study design: Prospective study

Methods: A total of 497 patients received unsedated TN-EGD with a 5.5 mm diameter endoscope or unsedated TO-EGD with endoscopes of 6.5 mm, 7.9 mm and 9.2 mm diameter. The rate of completion of pharyngeal observation and numbers of gag reflexes and cough reflexes were recorded.

Results: TN-EGD was performed in 175 patients and TO-EGD was performed in 322 patients. Pharyngeal observation was completed in 173 patients (98.9%) in the TN-EGD group and 235 patients (73.2%) in the TO-EGD group, a significant difference (p<0.001). The TN-EGD group had a low rate of occurrence of gag reflex (0.57%), in contrast, 28.3% of the TO-EGD group had a gag reflex, a significant difference (p<0.01). Multivariable analyses revealed that the use of TN-EGD was the only predictive factor for completion of pharyngeal observation (p<0.0001).

Conclusions: TN-EGD is ideally suited to observation of the pharynx by unsedated EGD.

Keywords: Cancer.; Pharynx; Transnasal EGD; Transoral EGD.

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Conflict of interest statement

CONFLICT OF INTEREST: None.

Figures

Fig 1
Fig 1
Rates of completion of pharyngeal observation. 98.9% received a complete pharyngeal observation in the TN-EGD group and 73.2% of the TO-EGD group received a complete pharyngeal observation (*p<0.001, chi-square test). TN-EGD; transnasal EGD, TO-EGD; transoral EGD.
Fig 2
Fig 2
Occurrence rates of (a) gag reflex and (b) cough reflex. (a) The occurrence rate of a gag reflex was 0.57% in the TN-EGD group and 28.3% in the TO-EGD group and there was a significant difference between the TN-EGD and TO-EGD groups (*p<0.01, chi-square test). (b) The occurrence rates of a gag reflex with the GIF-XP260 (6.5 mm diameter), GIF-PQ260 (7.9 mm) and GIF-Q260 (9.2 mm) were 31.7%, 22.1% and 26.9%, respectively (N.S.). TN-EGD; transnasal EGD, TO-EGD; transoral EGD, N.S.; not significant.
Fig 2
Fig 2
Occurrence rates of (a) gag reflex and (b) cough reflex. (a) The occurrence rate of a gag reflex was 0.57% in the TN-EGD group and 28.3% in the TO-EGD group and there was a significant difference between the TN-EGD and TO-EGD groups (*p<0.01, chi-square test). (b) The occurrence rates of a gag reflex with the GIF-XP260 (6.5 mm diameter), GIF-PQ260 (7.9 mm) and GIF-Q260 (9.2 mm) were 31.7%, 22.1% and 26.9%, respectively (N.S.). TN-EGD; transnasal EGD, TO-EGD; transoral EGD, N.S.; not significant.
Fig 3
Fig 3
Observation time for examining the pharynx. The time for successful pharyngeal examination was greater for the TN-EGD and GIF-XP260 (6.5 mm) groups. Bars are mean ± SD. **p<0.01, *p<0.05, unpaired t-test). TN-EGD; transnasal EGD, TO-EGD; transoral EGD, N.S.; not significant.
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