{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T11:32:30Z","timestamp":1744198350823},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,11,10]],"date-time":"2017-11-10T00:00:00Z","timestamp":1510272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Sniff test is a common method before unsedated transnasal esophago\u2010gastro\u2010duodenoscopy (UT\u2010EGD) to select a nostril insertion site. Yet there is no objective method to select a more specific meatus insertion tract for anesthesia and insertion. We devised an endoscopic meatus scoring scale by anterior meatuscopy to select the most optimal meatus insertion tract. We hypothesized that meatuscopy instead of sniff test might improve tolerance and reduce adverse events during nasal anesthesia and UT\u2010EGD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective randomized controlled trial to compare patient tolerance and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 359 patients were assessed and finally 310 patients were analyzed. There were no statistical differences in patient characteristics and insertion failure rates. Pain scores during nasal anesthesia, nasal insertion\/exsertion, UT\u2010EGD, and overall tolerance were significantly lower in the meatuscopy group than sniff test group. Compared with the sniff tested patients, the meatuscopied patients had significantly lower epistaxis rates during insertion\/exsertion, better visual capacity after decongestive anesthesia, and shorter total procedure time. A significantly higher proportion of the meatuscopied than sniff tested patients would like to receive the same procedure next time. Nasal discharge, nasal pain, epistaxis, and blowing out blood clots occurred significantly less frequent in the meatuscopy group than sniff test group. More sniff tested than meatuscopied patients had headache, delayed epistaxis, and sinusitis although they were not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Selection of an optimal meatus insertion tract by an anterior meatuscopy causes lesser nasal pain, epistaxis, and post\u2010procedural side effects in nasal anesthesia and UT\u2010EGD than the conventional sniff test.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13810","type":"journal-article","created":{"date-parts":[[2017,4,26]],"date-time":"2017-04-26T07:51:02Z","timestamp":1493193062000},"page":"1914-1921","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic meatus scoring scale <i>versus<\/i> sniff test to predict insertability before transnasal endoscopy: A prospective, randomized study"],"prefix":"10.1111","volume":"32","author":[{"given":"Chi\u2010Tan","family":"Hu","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Buddhist Tzu Chi General Hospital and Tzu Chi University  Hualien Taiwan"},{"name":"Graduate Institute of Clinical Medicine, School of Medicine Tzu Chi University  Hualien Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei\u2010Yi","family":"Lei","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Buddhist Tzu Chi General Hospital and Tzu Chi University  Hualien Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jen\u2010Shung","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Buddhist Tzu Chi General Hospital and Tzu Chi University  Hualien Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui\u2010Sheng","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Buddhist Tzu Chi General Hospital and Tzu Chi University  Hualien Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1335749"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20928"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.6003"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2003.59"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-41523"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000154741.25443.fe"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-995491"},{"key":"e_1_2_5_9_1","first-page":"842","article-title":"Pretreatment methods in transnasal endoscopy","volume":"58","author":"Iwamoto J","year":"2011","journal-title":"Hepato\u2010Gastroenterology"},{"key":"e_1_2_5_10_1","first-page":"224","article-title":"Unsedated transnasal versus conventional oral endoscopy in endoscopy na\u00efve patients","volume":"77","author":"Kadayifci A","year":"2014","journal-title":"Acta Gastroenterol. 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