Nasal route for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): An alternative modality in difficult oral bronchoscope insertion

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under moderate sedation through the oral approach. Oral insertion is performed owing to the larger size of the EBUS bronchoscope as well as the delicate and rigid distal end with an integrated ultrasound transducer assembly. Nasal route for EBUS scope insertion has been described as a feasible alternative. We herein report a patient wherein inability to introduce the EBUS bronchoscope through the mouth necessitated nasal insertion of the bronchoscope to successfully perform EBUS-TBNA. We discuss the relevant issues comparing the nasal and oral introduction of the EBUS bronchoscope.