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World J Gastrointest Endosc. Feb 16, 2014; 6(2): 41-48
Published online Feb 16, 2014. doi: 10.4253/wjge.v6.i2.41
Transnasal endoscopy: Technical considerations, advantages and limitations
Mustafa Atar, Abdurrahman Kadayifci
Mustafa Atar, Abdurrahman Kadayifci, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, United States
Abdurrahman Kadayifci, Division of Gastroenterology, Faculty of Medicine, University of Gaziantep, 27000 Gaziantep, Turkey
Author contributions: Atar M and Kadayifci A both contributed to this paper.
Correspondence to: Dr. Abdurrahman Kadayifci, MD, Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, 3-H GI Associates, Zero Emerson Place, Blossom St., Boston, MA 02114, United States. akadayifci@mgh.harvard.edu
Telephone: +1-857-9199934 Fax: +1-617-7245997
Received: November 29, 2013
Revised: January 9, 2014
Accepted: January 15, 2014
Published online: February 16, 2014
Processing time: 83 Days and 10 Hours
Abstract

Transnasal endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The primary goal of this method is to improve patient tolerance and convenience of the procedure. TNE can be performed without sedation and thus eliminates the risks associated with general anesthesia. In this way, TNE decreases the cost and total duration of endoscopic procedures, while maintaining the image quality of standard caliber endoscopes, providing good results for diagnostic purposes. However, the small working channel of the ultra-thin endoscope used for TNE makes it difficult to use for therapeutic procedures except in certain conditions which require a thinner endoscope. Biopsy is possible with special forceps less than 2 mm in diameter. Recently, TNE has been used for screening endoscopy in Far East Asia, including Japan. In most controlled studies, TNE was found to have better patient tolerance when compared to unsedated endoscopy. Nasal pain is the most significant symptom associated with endoscopic procedures but can be reduced with nasal pretreatment. Despite the potential advantage of TNE, it is not common in Western countries, usually due to a lack of training in the technique and a lack of awareness of its potential advantages. This paper briefly reviews the technical considerations as well as the potential advantages and limitations of TNE with ultra-thin scopes.

Keywords: Transnasal endoscopy; Transoral endoscopy; Ultra-thin endoscopy; Sedated endoscopy; Unsedated endoscopy

Core tip: Transnasal endoscopy with ultra-thin endoscopes improves patient tolerance and convenience of the procedure, prevents the risks associated with general anesthesia, and decreases the cost and total duration. However, there are some drawbacks of the procedure with the technical limitations of scopes. These are discussed briefly in this review.