Nasal insertion overall satisfaction with EUS-b (NOSE): evaluating the feasibility of transnasal diagnostic EUS-b.

Abstract

Esophageal endoscopic ultrasound using an endobronchial ultrasound (EBUS) bronchoscope (EUS‑b) has become an important tool in many bronchoscopy units. The procedure is generally performed through the mouth and there are currently no studies published evaluating the feasibility of transnasal EUS-b nor comparing it to the transoral approach. We aimed to evaluate the technical feasibility, patient comfort and safety of transnasal EUS-b. A single-centre prospective study enrolling patients undergoing diagnostic EUS-b was conducted. Nasal insertion was attempted in all cases. Procedure difficulty and perceived patient's comfort were reported by the bronchoscopists. Comfort, overall satisfaction and willingness to repeat the procedure were reported by the patients. Data regarding demographics, procedure details, patients' comfort and overall satisfaction, histological analysis and final diagnosis were collected and analysed. A total of 119 patients were consecutively enrolled. Nasal insertion was successful in 87.4% and the mean duration of the procedure was 15.7 ± 4.9 minutes. No severe complications were reported. Procedure difficulty was usually graded as "simple" or "very simple" (71.4%). Mean values for bronchoscopists' assessment of patient comfort and patients' reported comfort were 4.2 and 4.1, respectively, on a 5-point scale. Only moderate correlation between these values was found (τb = 0.301, P = 0.001). Willingness to repeat transnasal EUS-b was very high (99.0%). Adequate samples were obtained in 88.5% of patients and overall diagnostic yield of EUS‑b needle aspiration was 85.9%. EUS-b is an effective procedure that can be performed safely through the nasal cavity without significant discomfort for the patient.