Impact of Otolaryngology in the diagnosis of early oesophageal malignancy

IntroductionA large number of patients present in Otolaryngology clinics with vague upper gastro intestinal symptoms, some potentially originating from the oesophagus. In the United Kingdom there is no consensus for investigation protocols. The concern is that diagnosis of early oesophageal malignancy can be delayed with detrimental effects to the prognosis of the patient. The aim of this paper is to attempt to establish the impact of Ear Nose and Throat (ENT) work up in the diagnostic pathway of these patients.MethodsRetrospective analysis of case notes of newly diagnosed oesophageal carcinoma over a 15 month period.ResultsSixty five patients with a new diagnosis of oesophageal carcinoma were identified from the upper GI cancer network. A cohort of 7 patients was initially referred to ENT with related symptoms. Delays occurred at different stages during the course of their diagnostic pathways. Only 2 patients were diagnosed from ENT prior to referral to upper GI.ConclusionWe support the creation of one stop clinics incorporating the use of transnasal oesophagoscopy. The current literature is discussed.