TY - JOUR
T1 - Prospective multi-institutional transnasal esophagoscopy
T2 - Predictors of a change in management
AU - Howell, Rebecca J.
AU - Pate, Mariah B.
AU - Ishman, Stacey L.
AU - Isseroff, Tova F.
AU - Rubin, Adam D.
AU - Soliman, Ahmed M.
AU - Postma, Gregory N
AU - Pitman, Michael J.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - 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.
AB - 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.
KW - Eating Assessment Tool
KW - Transnasal esophagoscopy
KW - esophageal pathology
KW - head and neck cancer
KW - odynophagia
UR - http://www.scopus.com/inward/record.url?scp=84995872944&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84995872944&partnerID=8YFLogxK
U2 - 10.1002/lary.26171
DO - 10.1002/lary.26171
M3 - Article
C2 - 27531545
AN - SCOPUS:84995872944
VL - 126
SP - 2667
EP - 2671
JO - Laryngoscope
JF - Laryngoscope
SN - 0023-852X
IS - 12
ER -