Background: nasal route for upper endoscopy was first considered by Shaker (Gastrointest Endosc, 1994) and proposed as routinely diagnostic and selected therapeutic procedure by Barberani (It.J.Gastroent.Hepat. 1998) with his innovative technique. Aim: 1) to evaluate safety, feasibility and satisfaction rate of T-EGD from both medical and patient points of view, focusing by a multivariate analysis on final judgement influencing criteria 2) to evaluate effect of aromatized lubrification gel (eucalyptus, lemon or rose Sapimed-Italy) on pts satisfaction rate. Methods: 1006 pts (576M,430F;range 16-99) underwent T-EGD performed. Pts were divided in three groups in relation to previous experience of T-EGD (C), oral-EGD (B) or no previous endoscopy (A). Medical satisfaction rate was evaluated analyzing pts collaboration during T-EGD and technical difficulties in nasal insertion;safety was evaluated by complication incidence, monitoring cardiac frequency and O2 saturation; pts satisfaction was evaluated considering nasal discomfort, vomiting, burping and choking by means analogical scale (1-10). Aromatized gel effect was evaluated monitoring satisfaction rate of group C-patients (previous T-EGD with neutral gel). T-EGD were performed by means of Fuji-Olympus-Pentax 6 mm video-endoscope. Statistical analysis were performed by χ2 test for proportion and one way analysis variants for continuous data (R. Marmo MD, Italy); p < 0.05 was considered statistically significant. Results: Pts collaboration was bad(8,5%), good (47,6%) excellent (43,9%). No problems in nasal insertion in 81,4%, mild in 11%, high in 7,6% without differences between sex. Pts discomfort at the insertion was none (17,3%) mild (63,5%) high (19,2%). No pO2 variation before, during and after examination while cardiac frequency increased 9% during T-EGD(p < 0,0005). Complications rate was 0,3% (1 vertigo,2 epistaxis spontaneously recovered). Mild tearing in 50% and sneeze 10%. Vomiting was present in only 9,1%, burping in 10,8%, choking in 2,5%. In 6,1% of the pts was evident. ENT pathology Final judgement of pts about T-EGD was positive in 92%. 90% of pts appreciated aromatized gel and eucalyptus was favourite; T-EGD was more comfortable than previous with neutral gel in 91% of C group pts. The correlation between collaboration, nasal discomfort, symptoms, difficulty of nasal insertion, emphasize 10% of pts with negative judgment about T-EGD related to nasal and pharyngeal high sensitivity. Conclusions: T-EGD high satisfaction and safety were confirmed by both medical and patient point of view and are emphasized by using aromatized gel; nasal and pharyngeal high sensitivity could explain 10% of unsatisfacted pts that need sedation.