Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy

Background and study aims: Unsedated transnasal esophago-gastro-duodenoscopy (UT-EGD) has been performed for at least two decades but many techniques related to the procedure have yet to be standardized. We aimed to develope a simple endoscopic method, anterior meatuscopy, to replace the sniff test...
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Autor*in:	Chi-Tan Hu [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2015

Übergeordnetes Werk:	In: Endoscopy International Open - Georg Thieme Verlag KG, 2014, 03(2015), 06, Seite E538-E546
Übergeordnetes Werk:	volume:03 ; year:2015 ; number:06 ; pages:E538-E546

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.1055/s-0034-1392772

Katalog-ID:	DOAJ019754361

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520			\|a Background and study aims: Unsedated transnasal esophago-gastro-duodenoscopy (UT-EGD) has been performed for at least two decades but many techniques related to the procedure have yet to be standardized. We aimed to develope a simple endoscopic method, anterior meatuscopy, to replace the sniff test for selecting the most patent nasal meatus before UT-EGD. We hypothesized that access to the common nasal meatus (CNM), if confirmed by anterior meatuscopy, was a safer route than the inferior (INM) and middle nasal meatuses (MNM) because it would result in reduced epistaxis, nasal pain, and nasal discharge. Patients and methods: We used anterior meatuscopy and an endoscopic meatus scoring scale (EMSS) to identify the optimal meatus for insertion. We evaluated the EMSS frequency distributions for the INM, CNM, and MNM and the reliability of a sniff test in 1,000 consecutive patients. The adverse effects of passing through the CNM versus the INM and MNM, respectively, were compared. Results: In the INM and MNM, the EMSS frequencies were grade I < II < III < 0 whereas those in the CNM were grade II < I < 0 < III. A sniff test was not reliable, given its low sensitivity (63.3 %), specificity (67.3 %), positive predictive value (69.1 %), negative predictive value (61.4 %), and accuracy (65.2 %). Although only 9.2 % of our patients had grade III anterior-to-posterior CNMs, passage through this spacious CNM rather than through the MNM or the INM could significantly reduce epistaxis, nasal pain, and nasal discharge. Conclusions: Anterior meatuscopy is more reliable than a sniff test before UT-EGD. Transnasal endoscopic passage through the endoscopically patent CNM, if detected by anterior meatuscopy, may prevent epistaxis and nasal pain and minimize nasal discharge.
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allfieldsSound	10.1055/s-0034-1392772 doi (DE-627)DOAJ019754361 (DE-599)DOAJa2610d7f48a94283a5e43b8bec0cbb58 DE-627 ger DE-627 rakwb eng RC799-869 Chi-Tan Hu verfasserin aut Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and study aims: Unsedated transnasal esophago-gastro-duodenoscopy (UT-EGD) has been performed for at least two decades but many techniques related to the procedure have yet to be standardized. We aimed to develope a simple endoscopic method, anterior meatuscopy, to replace the sniff test for selecting the most patent nasal meatus before UT-EGD. We hypothesized that access to the common nasal meatus (CNM), if confirmed by anterior meatuscopy, was a safer route than the inferior (INM) and middle nasal meatuses (MNM) because it would result in reduced epistaxis, nasal pain, and nasal discharge. Patients and methods: We used anterior meatuscopy and an endoscopic meatus scoring scale (EMSS) to identify the optimal meatus for insertion. We evaluated the EMSS frequency distributions for the INM, CNM, and MNM and the reliability of a sniff test in 1,000 consecutive patients. The adverse effects of passing through the CNM versus the INM and MNM, respectively, were compared. Results: In the INM and MNM, the EMSS frequencies were grade I < II < III < 0 whereas those in the CNM were grade II < I < 0 < III. A sniff test was not reliable, given its low sensitivity (63.3 %), specificity (67.3 %), positive predictive value (69.1 %), negative predictive value (61.4 %), and accuracy (65.2 %). Although only 9.2 % of our patients had grade III anterior-to-posterior CNMs, passage through this spacious CNM rather than through the MNM or the INM could significantly reduce epistaxis, nasal pain, and nasal discharge. Conclusions: Anterior meatuscopy is more reliable than a sniff test before UT-EGD. Transnasal endoscopic passage through the endoscopically patent CNM, if detected by anterior meatuscopy, may prevent epistaxis and nasal pain and minimize nasal discharge. Diseases of the digestive system. Gastroenterology In Endoscopy International Open Georg Thieme Verlag KG, 2014 03(2015), 06, Seite E538-E546 (DE-627)780383214 (DE-600)2761052-4 21969736 nnns volume:03 year:2015 number:06 pages:E538-E546 https://doi.org/10.1055/s-0034-1392772 kostenfrei https://doaj.org/article/a2610d7f48a94283a5e43b8bec0cbb58 kostenfrei http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1392772 kostenfrei https://doaj.org/toc/2364-3722 Journal toc kostenfrei https://doaj.org/toc/2196-9736 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_267 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_2446 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 03 2015 06 E538-E546
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callnumber-first	R - Medicine
author	Chi-Tan Hu
spellingShingle	Chi-Tan Hu misc RC799-869 misc Diseases of the digestive system. Gastroenterology Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy
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topic_title	RC799-869 Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy
topic	misc RC799-869 misc Diseases of the digestive system. Gastroenterology
topic_unstemmed	misc RC799-869 misc Diseases of the digestive system. Gastroenterology
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title	Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy
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title_full	Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy
author_sort	Chi-Tan Hu
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title_sort	anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy
callnumber	RC799-869
title_auth	Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy
abstract	Background and study aims: Unsedated transnasal esophago-gastro-duodenoscopy (UT-EGD) has been performed for at least two decades but many techniques related to the procedure have yet to be standardized. We aimed to develope a simple endoscopic method, anterior meatuscopy, to replace the sniff test for selecting the most patent nasal meatus before UT-EGD. We hypothesized that access to the common nasal meatus (CNM), if confirmed by anterior meatuscopy, was a safer route than the inferior (INM) and middle nasal meatuses (MNM) because it would result in reduced epistaxis, nasal pain, and nasal discharge. Patients and methods: We used anterior meatuscopy and an endoscopic meatus scoring scale (EMSS) to identify the optimal meatus for insertion. We evaluated the EMSS frequency distributions for the INM, CNM, and MNM and the reliability of a sniff test in 1,000 consecutive patients. The adverse effects of passing through the CNM versus the INM and MNM, respectively, were compared. Results: In the INM and MNM, the EMSS frequencies were grade I < II < III < 0 whereas those in the CNM were grade II < I < 0 < III. A sniff test was not reliable, given its low sensitivity (63.3 %), specificity (67.3 %), positive predictive value (69.1 %), negative predictive value (61.4 %), and accuracy (65.2 %). Although only 9.2 % of our patients had grade III anterior-to-posterior CNMs, passage through this spacious CNM rather than through the MNM or the INM could significantly reduce epistaxis, nasal pain, and nasal discharge. Conclusions: Anterior meatuscopy is more reliable than a sniff test before UT-EGD. Transnasal endoscopic passage through the endoscopically patent CNM, if detected by anterior meatuscopy, may prevent epistaxis and nasal pain and minimize nasal discharge.
abstractGer	Background and study aims: Unsedated transnasal esophago-gastro-duodenoscopy (UT-EGD) has been performed for at least two decades but many techniques related to the procedure have yet to be standardized. We aimed to develope a simple endoscopic method, anterior meatuscopy, to replace the sniff test for selecting the most patent nasal meatus before UT-EGD. We hypothesized that access to the common nasal meatus (CNM), if confirmed by anterior meatuscopy, was a safer route than the inferior (INM) and middle nasal meatuses (MNM) because it would result in reduced epistaxis, nasal pain, and nasal discharge. Patients and methods: We used anterior meatuscopy and an endoscopic meatus scoring scale (EMSS) to identify the optimal meatus for insertion. We evaluated the EMSS frequency distributions for the INM, CNM, and MNM and the reliability of a sniff test in 1,000 consecutive patients. The adverse effects of passing through the CNM versus the INM and MNM, respectively, were compared. Results: In the INM and MNM, the EMSS frequencies were grade I < II < III < 0 whereas those in the CNM were grade II < I < 0 < III. A sniff test was not reliable, given its low sensitivity (63.3 %), specificity (67.3 %), positive predictive value (69.1 %), negative predictive value (61.4 %), and accuracy (65.2 %). Although only 9.2 % of our patients had grade III anterior-to-posterior CNMs, passage through this spacious CNM rather than through the MNM or the INM could significantly reduce epistaxis, nasal pain, and nasal discharge. Conclusions: Anterior meatuscopy is more reliable than a sniff test before UT-EGD. Transnasal endoscopic passage through the endoscopically patent CNM, if detected by anterior meatuscopy, may prevent epistaxis and nasal pain and minimize nasal discharge.
abstract_unstemmed	Background and study aims: Unsedated transnasal esophago-gastro-duodenoscopy (UT-EGD) has been performed for at least two decades but many techniques related to the procedure have yet to be standardized. We aimed to develope a simple endoscopic method, anterior meatuscopy, to replace the sniff test for selecting the most patent nasal meatus before UT-EGD. We hypothesized that access to the common nasal meatus (CNM), if confirmed by anterior meatuscopy, was a safer route than the inferior (INM) and middle nasal meatuses (MNM) because it would result in reduced epistaxis, nasal pain, and nasal discharge. Patients and methods: We used anterior meatuscopy and an endoscopic meatus scoring scale (EMSS) to identify the optimal meatus for insertion. We evaluated the EMSS frequency distributions for the INM, CNM, and MNM and the reliability of a sniff test in 1,000 consecutive patients. The adverse effects of passing through the CNM versus the INM and MNM, respectively, were compared. Results: In the INM and MNM, the EMSS frequencies were grade I < II < III < 0 whereas those in the CNM were grade II < I < 0 < III. A sniff test was not reliable, given its low sensitivity (63.3 %), specificity (67.3 %), positive predictive value (69.1 %), negative predictive value (61.4 %), and accuracy (65.2 %). Although only 9.2 % of our patients had grade III anterior-to-posterior CNMs, passage through this spacious CNM rather than through the MNM or the INM could significantly reduce epistaxis, nasal pain, and nasal discharge. Conclusions: Anterior meatuscopy is more reliable than a sniff test before UT-EGD. Transnasal endoscopic passage through the endoscopically patent CNM, if detected by anterior meatuscopy, may prevent epistaxis and nasal pain and minimize nasal discharge.
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title_short	Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy
url	https://doi.org/10.1055/s-0034-1392772 https://doaj.org/article/a2610d7f48a94283a5e43b8bec0cbb58 http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1392772 https://doaj.org/toc/2364-3722 https://doaj.org/toc/2196-9736
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A sniff test was not reliable, given its low sensitivity (63.3 %), specificity (67.3 %), positive predictive value (69.1 %), negative predictive value (61.4 %), and accuracy (65.2 %). Although only 9.2 % of our patients had grade III anterior-to-posterior CNMs, passage through this spacious CNM rather than through the MNM or the INM could significantly reduce epistaxis, nasal pain, and nasal discharge. Conclusions: Anterior meatuscopy is more reliable than a sniff test before UT-EGD. Transnasal endoscopic passage through the endoscopically patent CNM, if detected by anterior meatuscopy, may prevent epistaxis and nasal pain and minimize nasal discharge.</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Diseases of the digestive system. 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Anterior meatuscopy is more reliable than a sniff test for predicting nasal patency before transnasal endoscopy

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