Trans Nasal Endoscopy

TNE (Trans-Nasal Endoscopy)

A more comfortable way to have your necessary endoscopy

We have more than 1 option for your OGDS (Oesophagogastroduodenoscopy). Commonly done via your mouth, the latest option allows you the freedom of being more comfortable and at ease without the gagging.

Introducing TNE (Trans-Nasal Endoscopy).

What is it?

TNE is essentially an OGD scope but its access into the oesophagus is gained via the nostril using an ultrathin endoscope.

Is it something new?

No. It has been around for a long time and used in many different countries e.g. Japan and the USA

Why should I even consider this route?

  1. Conventional oral OGD (CO-OGD)
    Increased risk of adverse cardio-respiratory events, especially in elderly patients and patients with co-morbidities.
  2. CO-OGD without sedation
    Can be uncomfortable, which decreases the tolerability of the procedure, and thus potentially decrease the quality of examination as a result of retching and general discomfort.
  3. Sedation
    • Generally results in better patient tolerance and comfort, BUT,
    • Is associated with substantial cost and requires additional monitoring
    • May impact on patients day post procedure (e.g. unable to drive or work )
    • Increased total procedure time
    • Increased risk of adverse cardio-respiratory events, especially in elderly patients
    • Increased risk of adverse cardio-respiratory events, especially in elderly patients and patients with co-morbidities

What are its benefits?

  1. Its un-sedated approach avoids sedation related complications but if sedation is still required, it still avoids the gagging, choking sensation and retching associated with CO-OGD.
  2. It is by virtue of its route (i.e. reduced pharyngeal stimulation), the TNE leads to superior tolerability and therefore patient satisfaction.
  3. During the un-sedated TNE the patient is also able to speak and observe the procedure which allows the patient to discuss the endoscopic images with the gastroenterologist.
  4. In addition to being able to see the nasal cavity, pharynx, larynx and vocal cords, since TNE does not require a mouthpiece, it is also a useful technique in patients with dental problems or unconscious patients who cannot open their mouth.

Are there any limitations?

As with everything, limitations do exist and they include the need of nasal pretreatment (which is not a real limitation per se), may not be appropriate for patients with significant nasal problems and a narrow working channel limits every single therapeutic procedure delivery via the TNE.

In any case, this is a very comfortable alternative to the OGDS procedure and one that you should consider when making your decision.

Dr Loong Yik Yee
Designation
Consultant Physician and Gastroenterologist
Specialty
Internal Medicine, Gastroenterology and Hepatology, Gastroenterology
 




Dr Prabhjot Singh Sidhu
Designation
Consultant Gastroenterologist, Hepatologist and Physician
Specialty
Gastroenterology and Hepatology, Internal Medicine, Gastroenterology