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The physiologic impact of transnasal flexible endoscopy

Authors

  • Julina Ongkasuwan MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
    • 6701 Fannin St, Suite 610.22, Houston, TX 77030
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  • Katherine C. Yung MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A
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  • Mark S. Courey MD

    1. Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

Diagnostic transnasal flexible endoscopy (TNFE) is a commonly used office procedure in otolaryngology. Currently there is a paucity of data on the impact of TNFE on physiologic parameters. This is relevant with the advent of office-based endoscopic procedures. The goal of this study is to measure the impact of topical decongestion, anesthesia, and diagnostic TNFE on vital signs: systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), and oxygenation (O2 sat).

Study Design:

Prospective case control study, in which the patient is his/her control.

Methods:

Vital signs were obtained at baseline, immediately after the application of Neosynephrine, after the application of lidocaine, 5 minutes later, with the scope in the nasopharynx and hypopharynx, and upon completion of the procedure.

Results:

Compared to the baseline data, there was a statistically significant increase in HR after the procedure (mean change, 4.06 ± 10.15 bpm; range, −14 to 42 bpm, P = .01). There was also a change in O2 sat (mean change, 0.42% ± 1.36%; range −3% to 3%, P = .03) after the application of lidocaine. When comparing each data point to the preceding point, there was a statistically significant change in SBP with the scope in the nasopharynx (mean change, 5.34 ± 10.65 mm Hg; range, −22 to 28 mm Hg, P = .001) and in HR with the scope in the hypopharynx (mean change, 3.76 ± 6.41 bpm; range, −9 to 19 bpm, P = .0004).

Conclusions:

Diagnostic TNFE and topical lidocaine can have an impact on physiologic parameters; however, these changes are unlikely to be clinically significant.

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