We spoke with Dr. Alex Koral, Assistant Professor of Pediatrics (Gastroenterology), about Yale's Pediatric Transnasal Endoscopy Program.
What is Transnasal Endoscopy?
Unsedated transnasal endoscopy (TNE) is a procedure that can biopsy the gastrointestinal (GI) tract without needing sedation. During the procedure, a small endoscope, a small camera on a long tube, is placed into the nose and through the back of the mouth into the esophagus. The camera is able to visualize the esophagus and stomach, and biopsies are obtained through the endoscope. The results are similar to a traditional endoscopy, except there is no need for sedation. The patient is awake throughout the procedure and topical anesthetics are used to make the procedure more comfortable. During the procedure, the patient wears a headset and watches a show or movie to distract from the procedure. The whole procedure lasts about 10 minutes and patients can go home immediately after it is finished.
What kind of illness or disease does Transnasal Endoscopy help diagnose or treat?
TNE is primarily used to monitor diseases of the esophagus, including eosinophilic esophagitis and peptic esophagitis. The procedure is relatively new, and new applications are being pioneered that may help monitor swallowing issues, and disease of the stomach and intestine.
Why should families choose Yale for their TNE procedure?
Yale has one of the most experienced TNE programs in the country. We were the first program on the east coast and one of the first 10 in the country. We have written academic papers on TNE that are frequently cited by other physicians who use this technique. We can perform the procedure in New Haven and Greenwich, providing this service close to home, with no need to travel far to be taken care of.
What should parents and caregivers know about TNE?
TNE is preferable over traditional endoscopy for several reasons. The procedure does not require anesthesia, eliminating any possible side effects from sedation, decreasing the time required to fast (not eat or drink) prior to the procedure, and there is no recovery time following the procedure. Patients can go about their normal day as soon as they are done; go to school, play sports, or do any other activities they want to do. There is also no IV required. We use a topical numbing spray to limit discomfort from the procedure, but the sensation of the camera in the nose/mouth can be unpleasant. Some patients are unable to tolerate the procedure because of discomfort or anxiety, and a traditional endoscopy may be more suitable for some. If there are any questions about whether TNE is suitable for your child, please contact us and we can discuss with you.
Dr. Koral sees patients at the Pediatric Specialty Center at Yale New Haven Children's Hospital and the YNHCH Pediatric Specialty Center at Park Avenue Medical Center in Trumbull, CT.