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 Scopus citations

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
Publication statusPublished - Dec 1 2016

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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