This month in Scientific American™ Gastroenterology, Hepatology & Endoscopy:

  • Transnasal Functional Endoscopic Evaluation of Swallowing


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DISORDERS INVOLVING THE PHARYNX AND UPPER ESOPHAGUS

Transnasal Functional Endoscopic Evaluation of Swallowing

HIROSHI MASHIMO, MD, PhD
Associate Professor of Medicine, Director of Gastrointestinal Motility, Healthcare System, Harvard Medical School, Boston VA

Standard endoscopy routinely requires moderate sedation, and is less useful in oropharyngeal dysphagia. However, it is helpful in identifying mucosal abnormalities for possible biopsies, and is mandatory in cases where malignancy is suspected. Thinner (5 mm) transnasal endoscopes can be passed beyond the upper esophageal sphincter without sedation, and can be performed unassisted by a speech pathologist. This evaluation is generally well-tolerated at bedside or outpatient office, and the portability of the equipment makes this the favored approach for evaluating swallowing disorder, particularly for patients in the intensive care unit, after a stroke, or with chronic neuromuscular disorders.