Abstract
PurposeAlthough 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.MethodsProspective cohort study.ResultsForty-one procedures were performed, of which 35 were fully completed. The procedure was well tolerated with mild complaints such as nasal or pharyngeal pain and burping. Four complications occurred: two minor epistaxis and two vasovagal reactions. In patients with globus pharyngeus and/or dysphagia, transnasal esophagoscopy resulted in a cost saving of €94.43 (p 0.026) per procedure, compared to our regular diagnostic process. In patients with suspicion of hypopharyngeal carcinoma, cost savings were €831.41 (p 0.000) per case.ConclusionsCost analysis showed that office-based transnasal esophagoscopy can provide significant cost savings for the current standard of care. Furthermore, this procedure resulted in good patient acceptability and few complications.
Highlights
Inspection of the gastrointestinal tract with a flexible fiberoptic transoral endoscope became available in the late 1950s [1]
Endoscopes with smaller diameters became available, and the first studies were published on transnasal esophagoscopy (TNE) in the 1990s [4, 5]
Of the 20 patients that underwent TNE for globus pharyngeus and/or dysphagia, 4 cases (20%) revealed primary or residual laryngeal carcinoma and for 4 cases (20%) primary esophageal carcinoma
Summary
Inspection of the gastrointestinal tract with a flexible fiberoptic transoral endoscope became available in the late 1950s [1]. Since the 1980s, fiberoptic endoscopy has slowly been replaced by distal chip endoscopy. In these endoscopes, a charge-coupled device (CCD) chip is located in the tip of the endoscope and images are seen on a video screen [3]. Addition of a working channel in the digital endoscope and enhancement of image quality has transformed the field of diagnostic and therapeutic endoscopy. Through this ongoing development, endoscopes with smaller diameters became available, and the first studies were published on transnasal esophagoscopy (TNE) in the 1990s [4, 5]
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