In-office unsedated transnasal balloon dilation of the esophagus and trachea.

PURPOSE OF REVIEW: Since the advent of ultrathin flexible endoscopes with working channels office-based esophagoscopy and tracheobronchoscopy have been undertaken frequently by otolaryngologists. As a natural extension of these diagnostic procedures, more office-based esophageal and tracheal therapeutic procedures are being undertaken.

RECENT FINDINGS: Esophageal and tracheal balloon dilation can be performed in the unsedated patient using a transnasal approach. These transnasal techniques have not been described in the recent literature. Esophageal balloon dilation is a well-accepted technique for gastrointestinal endoscopists, and recent literature has focused on indications (such as cricopharyngeal dysfunction) and the development of removable stents for prevention of restenosis. Pulmonary balloon dilation is likewise well accepted, with recent literature focusing on the timing of intervention and the incidence of tracheobronchial laceration.

SUMMARY: Office-based esophageal and tracheal balloon dilations in unsedated patients are newly described techniques made possible with thin-caliber transnasal endoscopes.