2024 Volume 62 Issue 2 Pages 107-113
Objective: It has been reported that nasal breathing instead of mouth breathing during transnasal endoscopy reduces pharyngeal reflexes and improves tolerability of examinees. To determine whether recommendation of nasal breathing improves tumor detection rates, we compared the detection rates of esophageal browning, which is more frequent and widely used as a useful finding indicative of esophageal and pharyngeal cancer, between a control group not recommended nasal breathing and a group recommended such breathing. Subjects and Methods: We included 4,560 transnasal endoscopy examinations: 3,244 in the control group (2,042 males and 1,202 females, mean age: 54.7) and 1,316 in the nasal breathing group (821 males and 495 females, mean age 54.8) examined by the same three endoscopists using three endoscopes in both groups between 1 August 2020 and 31 January 2023. The brownish area was detected via image-enhanced endoscopic observation. Results: Up to 21 June 2022, 3,244 patients were examined without nasal breathing being recommended, and 52 people had a spotted brownish area (detection rate: 1.6%). On the other hand, after 21 June 2022, 1,316 patients were examined with nasal breathing being recommended, and 40 people had a brownish area (detection rate: 3.0%), showing a significant difference between the two groups. There was no significant difference in the frequency of discovering brownish areas between different endoscope models. Conclusion: Recommendation of nasal breathing in transnasal endoscopy is expected to contribute to the early detection of esophageal cancer with a high detection rate of a brown esophageal area.
