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Acta Otolaryngol 2021 Apr 7:1-5. Epub 2021 Apr 7.

Center for Voice and Swallowing, Department of Otolaryngology - Head and Neck Surgery, University of California Davis, Sacramento, CA, USA.

Background: Accurate tracheoesophageal prosthesis (TEP) size is essential for optimal functioning. Current sizing techniques do not afford direct visualization. The clinical utility of direct visualization with unsedated transnasal esophagoscopy (TNE) to improve TEP sizing accuracy has not been established. Read More

Clin Otolaryngol 2021 May 4;46(3):594-601. Epub 2021 Feb 4.

HNO-Zentrum beider Basel, Münchenstein, Switzerland.

Objective: Although laryngopharyngeal reflux (LPR) is a common condition in daily practice, no gold standard exists for its diagnosis. The objective of this study was to establish a simple and reliable scoring system for evaluating LPR consisting of both subjective and objective criteria.

Methods: This retrospective study includes 124 patients presenting with symptoms of LPR. Read More

Laryngoscope 2021 05 26;131(5):1088-1094. Epub 2020 Oct 26.

Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.

Objectives/hypothesis: Dysphagia encompasses a complex compilation of symptoms which often differ from findings of objective swallowing evaluations. The purpose of this investigation was to compare the results of subjective dysphagia measures to objective measures of swallowing in patients evaluated in a multidisciplinary dysphagia clinic.

Study Design: Prospective cohort study. Read More

Laryngoscope 2021 03 3;131(3):E807-E814. Epub 2020 Jul 3.

Department of Otolaryngology, Head and Neck Surgery, All India Institute of Medical Sciences New Delhi, Delhi, India.

Objectives: The primary objective was to determine the prevalence of synchronous esophageal squamous cell carcinoma in head and neck squamous cell carcinoma (HNSCC) patients. The secondary objective was to determine risk factors for the development of synchronous esophageal squamous cell carcinoma (ESCN).

Study Design: Cross sectional observation study. Read More

J Laryngol Otol 2020 Jun 18;134(6):481-486. Epub 2020 Jun 18.

ENT department, Lister Hospital, East and North Herts NHS Trust, Stevenage, UK.

Background: Advances in endoscopic technology have allowed transnasal oesophagoscopy to be used for a variety of diagnostic and therapeutic procedures.

Method: A review of the literature was carried out to look into the extended role of transnasal oesophagoscopy within otolaryngology, using the Embase, Cinahl and Medline databases.

Results: There were 16 studies showing that transnasal oesophagoscopy is safe and cost effective and can be used for removal of foreign bodies, tracheoesophageal puncture, laser laryngeal surgery and balloon dilatation. Read More

Otolaryngol Head Neck Surg 2020 09 26;163(3):455-458. Epub 2020 May 26.

Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

With encouraging signs of pandemic containment nationwide, the promise of return to a full range of clinical practice is on the horizon. Clinicians are starting to prepare for a transition from limited evaluation of emergent and urgent complaints to resumption of elective surgical procedures and routine office visits within the next few weeks to months. Otolaryngology as a specialty faces unique challenges when it comes to the COVID-19 pandemic due to the fact that a comprehensive head and neck examination requires aerosol-generating endoscopic procedures. Read More

Front Pediatr 2019 8;7:532. Epub 2020 Jan 8.

IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Pediatric Laryngo-Tracheal Stenosis (LTS) comprises different conditions that require precise preoperative assessment and classification. According to the guidelines, the optimal diagnostic work-up of LTS patients relies both on a comprehensive anamnesis and on endoscopic and radiological assessments. All the causes of LTS result in an impairment in airflow, mucociliary clearance, phonation, and sometimes in swallowing disorders. Read More

Laryngoscope 2020 12 19;130(12):E764-E766. Epub 2019 Dec 19.

Department of Otolaryngology-Head & Neck Surgery, Medical College of Georgia at Augusta University, Augusta, GA, U.S.A.

Curr Gastroenterol Rep 2019 Jul 25;21(9):42. Epub 2019 Jul 25.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Purpose Of Review: There has been an exponential increase in the incidence of esophageal adenocarcinoma (EAC) over the last half century. Barrett's esophagus (BE) is the only known precursor lesion of EAC. Screening for BE in high-risk populations has been advocated with the aim of identifying BE, followed by endoscopic surveillance to detect dysplasia and early stage cancer, with the intent that treatment can improve outcomes. Read More

Ear Nose Throat J 2019 Oct-Nov;98(9):NP142-NP143. Epub 2019 Apr 15.

Department of Otolaryngology, Head and Neck Surgery, Emory University, Atlanta, GA, USA.

Dermatomyositis is a rare multisystem autoimmune disorder occasionally accompanied by dysphagia. It is typically treated with immune modulating agents; however, dysphagia is often unresponsive to these. Previous reports have demonstrated the utility of videoflouroscopy and manometry in understanding the etiologies of dysphagia to inform a procedural target, historically the cricopharyngeus muscle. Read More

Otolaryngol Clin North Am 2019 Jun 22;52(3):577-587. Epub 2019 Mar 22.

Department of Otolaryngology, Voice, Airway and Swallowing Center, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA 30912, USA.

Dysphagia is a common complaint encountered in otolaryngology clinics. Approaching the patient with dysphagia starts with a comprehensive symptomatic analysis and thorough physical examination. The recent rapid revolution in office-based procedures has a great impact in the evaluation and management of dysphagia. Read More

Eur Arch Otorhinolaryngol 2019 May 26;276(5):1457-1463. Epub 2019 Feb 26.

Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Philips van Leydenlaan 15, 6500 HB, Nijmegen, The Netherlands.

Purpose: Although office-based transnasal esophagoscopy has been investigated extensively, a cost analysis is still lacking. We performed a cost analysis combined with feasibility study for two diagnostic processes: patients with globus pharyngeus and/or dysphagia, and hypopharyngeal carcinoma.

Methods: Prospective cohort study. Read More

Clin Gastroenterol Hepatol 2019 11 29;17(12):2455-2462. Epub 2019 Jan 29.

Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, University of Colorado School of Medicine; Aerodigestive Program, Children's Hospital Colorado.

Background & Aims: Evaluation and treatment of children with eosinophilic esophagitis (EoE) requires serial endoscopic, visual, and histologic assessment by sedated esophagogastroduodenoscopy (EGD). Unsedated transnasal endoscopy (TNE) was reported to be successful in a pilot study of children. We evaluated video goggle and virtual reality-based unsedated TNE in children with EoE, collecting data on rates of completion, adverse events, and adequacy of visual and histologic findings. Read More

Int Arch Otorhinolaryngol 2019 Jan 11;23(1):7-11. Epub 2018 Oct 11.

Department of ENT, Lancaster Royal Infirmary, Lancaster, United Kingdom of Great Britain and Northern Ireland.

 Transnasal esophagoscopy (TNE) is a widely used tool both in the diagnosis and treatment of patients presenting complaints within the head and the neck. This is because this investigative adjunct examination provides the advantage of visualizing above the level of the cricopharyngeus muscle when compared to the more widely used esophagogastroduodenoscopy (EGD).  We have assessed if the implementation of TNE within a district general hospital (DGH) was feasible, and investigated if the resources of our patients could be better directed away from other investigations such as barium swallow and EGD in favor of this novel technique. Read More

Laryngoscope 2019 12 13;129(12):2721-2726. Epub 2018 Dec 13.

Department of Otolaryngology-Head and Neck Surgery, Norfolk and Norwich University Hospital, Norwich, United Kingdom.

Objectives/hypothesis: To present yield of transnasal esophagoscopy (TNE) biopsies of upper aerodigestive tract (UADT) lesions and define the role of TNE as a safe alternative to rigid endoscopy.

Study Design: Retrospective case series.

Methods: All patients who underwent TNE-guided biopsies attempted over a 2-year period were included. Read More

Gastrointest Endosc 2019 04 29;89(4):712-722.e3. Epub 2018 Oct 29.

Department of Gastroenterology and Hepatology, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands.

Background And Aims: Barrett's esophagus (BE) screening is currently not considered to be cost effective in the general population but may be effective in high-risk subgroups, such as 50-year-old white men with chronic reflux disease (GERD). A new modality for screening is unsedated transnasal endoscopy using endosheath technology (uTNE), which has been shown to be safe and effective in clinical practice. In this study, we determined the cost-utility of uTNE in a high-risk subgroup compared with no screening or screening with standard endoscopy. Read More

J Pediatr Gastroenterol Nutr 2019 08;69(2):e54

Digestive Health Institute, Section of Pediatric Gastroenterology, Hepatology and Nutrition.

Thorac Surg Clin 2018 Nov;28(4):453-464

Esophageal and Lung Institute, Allegheny Health Network, Western Pennsylvania Hospital, Suite 158, Mellon Pavilion, 4815 Liberty Avenue, Pittsburgh, PA 15224, USA. Electronic address:

In Western countries, the incidence of esophageal adenocarcinoma has increased rapidly in parallel with its premalignant condition, Barrett esophagus (BE). Unlike colonoscopy, endoscopic screening for BE is not currently recommended for all patients; however, surveillance endoscopy is advocated for patients with established BE. Novel imaging and sampling techniques have been developed and investigated for the purpose of improving the detection of Barrett esophagus, dysplasia, and neoplasia. Read More

Ann Otol Rhinol Laryngol 2018 Dec 21;127(12):926-930. Epub 2018 Sep 21.

3 Department of Speech and Hearing Sciences, Indiana University, Bloomington, IN, USA.

Introduction:: The aim of this study was to evaluate the current indications for and clinical factors influencing the use of transnasal esophagoscopy (TNE).

Methods:: An online survey was sent to American Broncho-Esophagological Association members, including questions on demographics, indications, and factors influencing the use of TNE.

Results:: Sixty of 251 members (24%) completed the survey. Read More

HNO 2018 Jul;66(7):534-542

Department of Otolaryngology Head and Neck Surgery, Hospital Universitario Puerta de Hierro Majadahonda, 1 Manuel de Falla Street, Majadahonda, 28222, Madrid, Spain.

Eosinophilic esophagitis (EoE) is a recently recognised pathologic entity whose prevalence has risen significantly since first being described in 1993. Defined as a chronic, local immune-mediated disease with predominant eosinophil infiltration, it is nowadays the leading cause of dysphagia and food bolus impaction in children and young adults. Genetic and environmental risk factors, and especially food antigens, trigger the disease and are in the focus of investigation as avoidance can cure three quarters of patients. Read More

J Otolaryngol Head Neck Surg 2018 May 15;47(1):35. Epub 2018 May 15.

Center for Voice and Swallowing, Department of Otolaryngology - Head & Neck Surgery, University of California Davis, Sacramento, CA, USA.

Background: Cricopharyngeus muscle dysfunction (CPMD) is a common cause of dysphagia. We employ a progressive series of three double-balloon dilations separated by 4-6 weeks between procedures as a primary treatment option. The purpose of this study was to evaluate subjective, functional and objective improvement in swallowing after three serial dilations for CPMD. Read More

Clin Otolaryngol 2018 Apr 10. Epub 2018 Apr 10.

Department of Gastroenterology, Royal Cornwall Hospital, Truro, UK.

Objectives: Dysphagia is a presenting symptom of both pharyngeal and oesophageal cancers. The referral pathway choice is determined by whether it is thought to be oropharyngeal or oesophageal, and this is in turn influenced by whether dysphagia is perceived to be above or below the suprasternal notch. We studied the concordance between the presence of pharynx-localised dysphagia (PLD) and the location of the underlying disease processes. Read More

J Otolaryngol Head Neck Surg 2018 Apr 3;47(1):23. Epub 2018 Apr 3.

Department of Otolaryngology-Head and Neck Surgery, University of Toronto, St-Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.

Background: The advent of chip tip technology combined with advanced endoscopy has revolutionized the field of laryngology in the past decade. Procedures such as transnasal esophagoscopy, site-specific steroid injections, injection laryngoplasty and laryngeal laser treatment can now be performed in the office setting under local anaesthesia. Although In-Office Laryngeal Procedures (IOLPs) have become standard-of-care in many American and several Canadian centers, there are no guidelines regulating the practice of these procedures. Read More

Laryngoscope 2018 10 8;128(10):2261-2267. Epub 2018 Feb 8.

Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.

Objective: To review experience, safety, and cost of office-based esophageal dilation in patients with history of head and neck cancer (HNCA).

Methods: The medical records of patients undergoing esophageal dilation in the office were retrospectively reviewed between August 2015 and May 2017. Patients were given nasal topical anesthesia. Read More

Liver Int 2018 08 10;38(8):1418-1426. Epub 2018 Feb 10.

Gastroenterology Department, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.

Background & Aims: Unsedated transnasal endoscopy may be used for detecting oesophageal varices. However, few studies evaluated feasibility and accuracy of this technique. We aimed to evaluate accuracy, interobserver agreement and safety of the transnasal ultrathin compared to conventional endoscopy in patients with cirrhosis. Read More

Clin Otolaryngol 2018 06 25;43(3):924-928. Epub 2018 Jan 25.

Department of Otolaryngology-Head and Neck Surgery, Norfolk and Norwich University Hospital, Norwich, UK.

Ear Nose Throat J 2017 Dec;96(12):E44

Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, GA, USA.

Logoped Phoniatr Vocol 2019 Jul 9;44(2):67-72. Epub 2017 Nov 9.

a Department of Otorhinolaryngology - Head and Neck Surgery , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.

Globus may be a persistent symptom impairing patients' quality of life. Diagnostics and treatment are controversial but some globus patients may benefit from reassurance and attention. We investigated how globus symptoms change during a short-term follow-up without any treatment after an examination by an ear, nose and throat (ENT) physician and further diagnostic procedures. Read More

Gastrointest Endosc Clin N Am 2017 Jul 4;27(3):379-396. Epub 2017 Apr 4.

MRC Cancer Unit, Hutchinson/MRC Research Centre, University of Cambridge, Box 197, Cambridge Biomedical Campus, Cambridge CB2 0XZ, UK.

Barrett's esophagus (BE) predisposes patients to esophageal adenocarcinoma. 3 to 6% of individuals with gastro-esophageal reflux disease are estimated to have BE but only 20 to 25% of BE patients are currently diagnosed. The current gold standard for diagnosis of BE is per-oral upper GI endoscopy. Read More

J Pediatr Gastroenterol Nutr 2018 01;66(1):33-36

Department of Pediatrics.

Monitoring therapy in esophageal inflammatory disorders such as eosinophilic esophagitis and reflux esophagitis often requires frequent endoscopic evaluation. We recently reported the effective use of unsedated in-office transnasal esophagoscopy that significantly decreased costs and anesthetic exposure associated with pediatric esophagoscopy in eosinophilic esophagitis. Here we report a series of pediatric patients with esophagitis with gastrostomy tubes who underwent unsedated transgastrostomy esophagoscopy (TGE) in an office setting. Read More