Prospective multi-institutional transnasal esophagoscopy

Predictors of a change in management

Rebecca J. Howell, Mariah B. Pate, Stacey L. Ishman, Tova F. Isseroff, Adam D. Rubin, Ahmed M. Soliman, Gregory N Postma, Michael J. Pitman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives/Hypothesis: To evaluate clinical indications and endoscopic findings for patients undergoing transnasal esophagoscopy (TNE). Study Design: Prospective, multi-institutional, observational cohort study at four tertiary centers. Methods: Demographics, reflux finding score, reflux symptom index, Eating Assessment Tool (EAT-10) scores, clinical indications, and endoscopic findings were compared among patients whose TNE findings resulted in a changes in management (FCIM), defined as a referral, new medication, or surgery recommendation. Results: Of the 329 patients who were enrolled nine (3%) were unable to complete the exam. In an adjusted regression model, male gender and elevated body mass index were significantly predictive of a positive TNE (P =.013-.045); 51% (n = 162/319) had TNE with FCIM. Common FCIM were esophageal stricture (7.5%), irregular Z-line (27.4%), reflux esophagitis (12.8%), and infectious esophagitis (6.3%) (P <.001-.010). Overall, the average EAT-10 was higher for patients with FCIM (9.7 vs. 5.4) than in those without it (P =.014). Patients with a history of head and neck cancer (HNCA) had FCIM 64% of the time, which rose to 81% if they had both HNCA and dysphagia. Conclusions: In treatment-seeking patients TNE is predictive of a change in management in males and obese patients. In patients with HNCA and dysphagia, TNE is likely to yield findings that cause a change in management. Level of Evidence: 2b. Laryngoscope, 126:2667–2671, 2016.

Original languageEnglish (US)
Pages (from-to)2667-2671
Number of pages5
JournalLaryngoscope
Volume126
Issue number12
DOIs
StatePublished - Dec 1 2016

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Esophagoscopy
Head and Neck Neoplasms
Deglutition Disorders
Laryngoscopes
Esophageal Stenosis
Peptic Esophagitis
Esophagitis
Observational Studies
Body Mass Index
Cohort Studies
Referral and Consultation
Eating
Demography
Prospective Studies

Keywords

  • Eating Assessment Tool
  • Transnasal esophagoscopy
  • esophageal pathology
  • head and neck cancer
  • odynophagia

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Howell, R. J., Pate, M. B., Ishman, S. L., Isseroff, T. F., Rubin, A. D., Soliman, A. M., ... Pitman, M. J. (2016). Prospective multi-institutional transnasal esophagoscopy: Predictors of a change in management. Laryngoscope, 126(12), 2667-2671. https://doi.org/10.1002/lary.26171

Prospective multi-institutional transnasal esophagoscopy : Predictors of a change in management. / Howell, Rebecca J.; Pate, Mariah B.; Ishman, Stacey L.; Isseroff, Tova F.; Rubin, Adam D.; Soliman, Ahmed M.; Postma, Gregory N; Pitman, Michael J.

In: Laryngoscope, Vol. 126, No. 12, 01.12.2016, p. 2667-2671.

Research output: Contribution to journalArticle

Howell, RJ, Pate, MB, Ishman, SL, Isseroff, TF, Rubin, AD, Soliman, AM, Postma, GN & Pitman, MJ 2016, 'Prospective multi-institutional transnasal esophagoscopy: Predictors of a change in management', Laryngoscope, vol. 126, no. 12, pp. 2667-2671. https://doi.org/10.1002/lary.26171
Howell RJ, Pate MB, Ishman SL, Isseroff TF, Rubin AD, Soliman AM et al. Prospective multi-institutional transnasal esophagoscopy: Predictors of a change in management. Laryngoscope. 2016 Dec 1;126(12):2667-2671. https://doi.org/10.1002/lary.26171
Howell, Rebecca J. ; Pate, Mariah B. ; Ishman, Stacey L. ; Isseroff, Tova F. ; Rubin, Adam D. ; Soliman, Ahmed M. ; Postma, Gregory N ; Pitman, Michael J. / Prospective multi-institutional transnasal esophagoscopy : Predictors of a change in management. In: Laryngoscope. 2016 ; Vol. 126, No. 12. pp. 2667-2671.
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abstract = "Objectives/Hypothesis: To evaluate clinical indications and endoscopic findings for patients undergoing transnasal esophagoscopy (TNE). Study Design: Prospective, multi-institutional, observational cohort study at four tertiary centers. Methods: Demographics, reflux finding score, reflux symptom index, Eating Assessment Tool (EAT-10) scores, clinical indications, and endoscopic findings were compared among patients whose TNE findings resulted in a changes in management (FCIM), defined as a referral, new medication, or surgery recommendation. Results: Of the 329 patients who were enrolled nine (3{\%}) were unable to complete the exam. In an adjusted regression model, male gender and elevated body mass index were significantly predictive of a positive TNE (P =.013-.045); 51{\%} (n = 162/319) had TNE with FCIM. Common FCIM were esophageal stricture (7.5{\%}), irregular Z-line (27.4{\%}), reflux esophagitis (12.8{\%}), and infectious esophagitis (6.3{\%}) (P <.001-.010). Overall, the average EAT-10 was higher for patients with FCIM (9.7 vs. 5.4) than in those without it (P =.014). Patients with a history of head and neck cancer (HNCA) had FCIM 64{\%} of the time, which rose to 81{\%} if they had both HNCA and dysphagia. Conclusions: In treatment-seeking patients TNE is predictive of a change in management in males and obese patients. In patients with HNCA and dysphagia, TNE is likely to yield findings that cause a change in management. Level of Evidence: 2b. Laryngoscope, 126:2667–2671, 2016.",
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