Incidental Otolaryngologic Pathology Noted Upon Esophagogastroduodenoscopy: Case Series and Review of Literature

Objectives: We report and analyze eight cases in which patients were referred from gastroenterology (GI) to otolaryngology following esophagogastroduodenoscopy (EGD). We aim to provide specific examples of head and neck pathology encountered by gastroenterologists during upper endoscopy. Methods: A series of eight cases between 2016 and 2019 were analyzed by chart review. In each case, otolaryngology consultation was requested after an abnormality was noticed by a gastroenterologist during EGD. Subsequent laryngoscopy or bronchoscopy was performed in all cases allowing for image comparison. Select images comparing EGD to laryngoscopy findings are included as well as a literature review concerning the nature of communication between the two specialties. Results: Eight adult patients were referred to otolaryngology for abnormalities noted by a gastroenterologist during EGD at the following anatomic sites: soft palate (n=1), base of tongue (n=2), glottis (n=3), and interarytenoid mucosa (n=1). Additionally, a potential airway foreign body was noted on EGD which was ultimately determined to represent normal subglottic anatomy by bronchoscopy. Some 5/8 (63%) cases were considered true pathology while 3/8 (37%) represented normal anatomy or anatomic variants upon subsequent otolaryngologic evaluation. Conclusions: There is minimal literature regarding the nature of referrals from GI to otolaryngology following EGD. Our findings suggest that EGD offers a unique opportunity for early detection of otolaryngologic pathology. However, certain inter-specialty anatomic knowledge gaps were noted which contributed to occasional unnecessary referrals, procedures, and associated patient anxiety. We hope that the results of this study can inform future research aimed at improving communication and collaboration between the two specialties.