During your first visit to the Ruysdael Clinics, the ENT doctor will question you about your problem with swallowing. Afterwards, he will examine the throat with a thin endoscope through the nose and check the throat for deviations. From tonsils to the vocal cords and entrance of the esophagus, the mucous membrane can then be assessed for abnormalities and the doctor will check whether the muscles contract properly when swallowing.
ENDOSCOPY THROUGH THE NOSE (TNE)
The Ruysdael Clinics is one of the few clinics in the Netherlands where an endoscopy of the throat, esophagus and stomach is performed through the nose. This Trans Nasal Esophagoscopy (TNE or TNO) is done with a very thin tube with a very small camera at the end. This tube is called an endoscope. The endoscope is inserted through the nose. This way the examination is much less stressful than a scopie through the mouth.
The examination is carried out by an ENT doctor who is familiar with the anatomy of the nose, throat and esophagus. The endoscope can rotate in all directions so the stomach can be seen, next to the throat and the esophagus. If necessary, a small biopsy forceps is inserted through the endoscope to remove a piece of abnormal tissue for examination by the pathologist.
The examination is viewed on a large screen and the results are discussed with you immediately afterwards. If tissue has been taken for pathological examination, an appointment will be made to discuss the outcome. If necessary, you will be referred to a gastrointestinal and liver doctor directly. In case of malice tissue, we will refer you to the Antoni van Leeuwenhoek Hospital.
In the US, this new form of examination has largely taken the place of the traditional endoscopy by the gastrointestinal liver doctor. In the traditional endoscopy a more than twice as thick endoscope is used, which is inserted through the mouth. With this type of endoscope oftentimes anesthesia is needed because of gag reflexes. Patient research confirms that the examination through the nose with a much thinner endoscope is perceived by patients as far less stressful.
The Ruysdael Clinics works closely with Olympus in researching and treating swallowing problems. Olympus is a global leader in the field of advanced ENT equipment.
PHOTO OR VIDEO OF SWALLOWING
Sometimes an X-ray of the throat needs to be made. To do so, you will be given a drink with contrast fluid in it. Constrictions, bulges and irregular mucous membrane of the throat or esophagus can be seen on the X-ray. Also thickening of the bone of the spine can be detected, which can press in the back of the throat. A swallow video is created in the same way, by taking multiple images per second which make up the video. In this case, different thicknesses of liquid and food are used, to asses problems per type of food and drink. In case of a video, the functional part of the swallowing is mainly looked at.