Implementation of transnasal esophagoscopy examination in tertiary referral hospital

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ENT doctor examines a patient. (Source: Halodoc)

The esophagus is an organ in the upper gastrointestinal tract, a tube with muscles that serves to deliver the food bolus that enters through the mouth into the stomach. The esophagus plays a role in the ingestion process starting from the oral and pharyngeal phases. Disruption of process in the esophageal phase can be characterized by complaints of difficulty swallowing, a burning sensation in the chest and other complaints. Efforts to detect abnormalities in the esophagus early require endoscopic examination to see the esophageal lumen. If abnormalities are found, appropriate treatment can be made.

Endoscopic examination of the esophagus is called esophagoscopy. Esophagoscopy is the standard examination standard for evaluating, diagnosing, screening and monitoring esophageal diseases. Esophagoscopy that is commonly done in the Otorhinolaryngology Head and Neck Surgery field is rigid esophagoscopy that requires sedation. Procedures using sedation have advantages and disadvantages.

A technological breakthrough, esophagoscopy can be done without sedation namely transnasal esophagoscopy. Small scope transnasal esophagoscopy without sedation provides efficiency and accurate endoscopic assessment of the esophagus, with a lower risk than procedures with sedation and can be used as a method for screening esophageal diseases in health centers.

Transnasal esophagoscopy is able to detect abnormalities in the esophagus and can be used as an evaluation tool for head and neck malignancies based on the American Society for Gastrointestinal Endoscopy (ASGE). The role of transnasal esophagoscopy is very high for examining aerodigestive tract without the risk of using general anesthesia and The American Broncho Esophagology Association claimed that it has the same benefits as panendoscopy in the operating theater.

Patients with complaints of dysphagia, heart burns, or a history of malignancy in the head and neck that require screening for esophageal metastases have an indication of transnasal esophagoscopy. Dysphagia complaints are found mostly in the age range of 51-70 years because in elderly, the swallowing process is decreased in quality and effectiveness because it is associated with anatomic or physiological deficits in the mouth, pharynx, larynx, and esophagus.

Furthermore, head and neck malignancies are commonly found in men and in elderly age range. Complaints of heart burn in GERD patients as well as complaints related to pharyngeal reflux are also one indication of an trasnasal esophagoscopy examination. (*)

Author: Rizka Fathoni Perdana

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