Transnasal esophagoscopy, as it is termed in the USA and elsewhere, is better known in the UK as transnasal flexible laryngo-oesophagoscopy. This is the term used to describe the examination of the larynx, pharynx and the entire length of the oesophagus using a flexible endoscope narrow enough to be introduced through the nose, using only local anaesthesia. This examination is transforming the way in which otolaryngologists are examining these areas in the out-patient setting, recording their findings with crystal clear, moving images, and carrying out biopsies and other therapeutic manoeuvres.

This Atlas of Transnasal Esophagoscopy, in its 108 pages, provides a simple and easy-to-read introduction to the subject. The book is clearly written and well set out, with chapters that take the reader through ‘Indications’, ‘Technique and Endoscopic Anatomy’ and the ‘Normal Examination’, followed by nicely illustrated sections covering common benign and malignant pathologies. I would have liked to see more detail on the local anaesthetic technique used by the authors, as the procedure can succeed or fail depending on the success of the anaesthetic. Finally, there is a chapter describing some of the procedures which can easily be accomplished with this technique, such as biopsy, tracheo-oesophageal puncture and valve insertion, use of a laser via the instrument channel, and oesophageal dilatation.

There is no doubt that this technology is already beginning to have a significant impact in a number of major ENT units in this country. It can provide a one-stop diagnostic service, sparing many patients both radiological investigations and in-patient endoscopy in the exclusion of significant disease and, for others, providing prompt diagnosis. The equipment is expensive but the potential savings, in terms of beds and other hospital resources, are considerable.

For those of you who are not familiar with the technique of transnasal oesophagoscopy, I would urge you very strongly to read this book and, for those of you contemplating setting up a service, this slim volume will provide a very useful guide and reference book.