Transnasal endoscopy: Technical considerations, advantages and limitations

Table 1 Patients’ evaluation of transnasal endoscopy and transoral endoscopy by visual analog scale (mean ± SD)[34]

Evaluation criteria	TOE	TNE
Pain inside the nosea	1.2 ± 0.7	3.4 ± 1.9
Pain in the throata	4.3 ± 2.5	1.7 ± 0.8
Retching and breathlessness feelinga	5.4 ± 3.1	2.1 ± 1.4
Abdominal discomfort and paina	3.9 ± 1.7	2.3 ± 1.2
Tolerabilitya	4.8 ± 2.4	2.6 ± 2.1
Overall distress and difficultya	4.4 ± 2.9	3.1 ± 1.8

TNE: Transnasal endoscopy; TOE: Transoral endoscopy. Visual analog scale: 0 = none; 10 = unbearable.

^aP < 0.05.

Table 2 Advantages and limitations of transnasal endoscopy

Advantages of transnasal endoscopy	Limitations of transnasal endoscopy
More comfortable and tolerable than unsedated TOE	Needs nasal pretreatment
Safer and cost-effective than sedated TOE	Nasal pain and discomfort
Elimination of all side effects due to sedation	Mild epistaxis
Total procedure time is shorter than sedated TOE	Limited functionality (suction, air, water)
No or minimal hemodynamic changes	Extreme flexibility of scope body
No intravenous line is necessary routinely	Narrow working channel. Not appropriate for through the scope interventional procedures
Patient can speak, watch and discuss during procedure	Needs extra training
No need for mouthpiece	No HD image capabilities
Evaluation of nasal cavity, pharynx and larynx	Higher insertion failure rate
Can be done in sitting position	Longer examination time
Visual satisfaction for patients	Not appropriate for patients with nasal problems

TOE: Transoral endoscopy; HD: High-definition.