Transnasal Esophagoscopy (TNE) - Atlanta ENT Institute | Ear, Nose and Throat Specialists in Georgia

Transnasal Esophagoscopy (TNE)

Esophagoscopy Services For Atlanta

Transnasal esophagoscopy (TNE) is technology that examines the esophagus, the swallowing tube between the throat and stomach, without the patient being put to sleep. Most commonly, this is done to check for cancer and other esophageal disorders while patients are awake, comfortable, and without pain, using TNE. 

Anyone who has difficulty swallowing, painful swallowing or dysphagia, or who had acid reflux, should have a TNE examination. TNE is currently the best method for screening the esophagus for trouble. Depending on the findings of the TNE, other diagnostics may be needed.

Transnasal esophagoscopy (TNE) translates to “through-the-nose examination” of the esophagus, which is done by numbing one side of the nose with xylocaine and then sliding a small, flexible tube through the nose; then bypassing the throat area, and going straight into the opening of the esophagus behind the larynx (voice box). The TNE examination is every bit as comprehensive and thorough as older more expensive and invasive methods that require sedation in a special endoscopy facility. In 2001, Dr. Koufman first reported a series of TNE patients.

In the years since its introduction, TNE has not proliferated rapidly. At this point, there may be  as many as 125 million Americans who need esophageal screening, and at present about 10 million esophageal examinations are performed each year, mostly by gastroenterologists in expensive facilities with the patients under sedation.  The sedated (GI) endoscopy industry costs America more than $50 billion per year; however, TNE is the safer, less-expensive, and more accurate alternative.

“Anyone with acid reflux or who has chronic hoarseness, heartburn, indigestion,sore throat, difficulty swallowing (dysphagia), or chronic cough should have a screening transnasal esophagoscopy performed to rule out Barrett’s esophagus or esophageal cancer.”   – Dr. Jamie A. Koufman

Epidemic Acid Reflux, Barrett’s Esophagus, and Esophageal Cancer

Acid reflux is a high-prevalence disease which comes in two forms: laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD). Typically, LPR patients have reflux during the day without having heartburn or esophagitis; whereas GERD patients tend to have heartburn and reflux more at night.

Acid reflux disease has increased dramatically in the past 50 years, growing on average 4% per year. In 2010, we did a study to estimate the prevalence of reflux in America, finding that 40% had reflux disease with 22% having GERD and another 18% (118/656) having LPR. One of the most striking findings was that 37% of the 21-30 year-old age group had reflux. 

During the same 50 year period, esophageal cancer increased 800%, and in addition, it is now seven-times more deadly. Equally important, Barrett’s esophagus, the precursor to esophageal cancer, is now being seen in 7%-10% of people with LPR and GERD; meaning patients with hoarseness, chronic cough, sore throat, and heartburn. Routine esophageal screening for both LPR and GERD patients is recommended.


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