Cost analysis of office-based transnasal esophagoscopy

Eur Arch Otorhinolaryngol. 2019 May;276(5):1457-1463. doi: 10.1007/s00405-019-05357-0. Epub 2019 Feb 26.


Purpose: Although office-based transnasal esophagoscopy has been investigated extensively, a cost analysis is still lacking. We performed a cost analysis combined with feasibility study for two diagnostic processes: patients with globus pharyngeus and/or dysphagia, and hypopharyngeal carcinoma.

Methods: Prospective cohort study.

Results: Forty-one procedures were performed, of which 35 were fully completed. The procedure was well tolerated with mild complaints such as nasal or pharyngeal pain and burping. Four complications occurred: two minor epistaxis and two vasovagal reactions. In patients with globus pharyngeus and/or dysphagia, transnasal esophagoscopy resulted in a cost saving of €94.43 (p 0.026) per procedure, compared to our regular diagnostic process. In patients with suspicion of hypopharyngeal carcinoma, cost savings were €831.41 (p 0.000) per case.

Conclusions: Cost analysis showed that office-based transnasal esophagoscopy can provide significant cost savings for the current standard of care. Furthermore, this procedure resulted in good patient acceptability and few complications.

Keywords: Cost analysis; Head and neck oncology; Office-based; Topical anesthesia; Transnasal esophagoscopy.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / economics*
  • Ambulatory Care / methods
  • Cost Savings / statistics & numerical data
  • Cost-Benefit Analysis*
  • Deglutition Disorders / diagnostic imaging*
  • Deglutition Disorders / etiology
  • Esophagoscopy / economics
  • Esophagoscopy / methods*
  • Feasibility Studies
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Hypopharyngeal Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Netherlands
  • Nose
  • Pharyngeal Diseases / diagnostic imaging*
  • Prospective Studies