Transnasal Tracheoscopy (TNT)

Who is a candidate for Transnasal Tracheoscopy?

  • Individuals with suspected narrowing of the airway (larynx and trachea) at or below the level of the vocal cords. The larynx (voice box) and trachea (windpipe). They may have symptoms of air hunger or airway restriction pariticularly with exertion or exercise. They may make noises (stridor) from the airway either breathing in (inspiratory stridor) breathing out (expiratory stridor) or both (biphasic stridor).
  • Individuals who are about to undergo surgery to expand the narrowed airway.
  • Individuals who have had surgery to expand the airway and need an evaluation of their results.
  • Individuals who have a tracheotomy and need to have their airway evaluated to make sure it is safe to remove their tracheotomy tube.

What is involved in Transnasal Tracheoscopy?

TNT takes less than 30 minutes and can be incorporated into a standard office visit. It can also be scheduled as a separate short procedure. The procedure is performed in the office without sedation. Patients can drive themselves home and wear standard street clothing.


Patients sit in a standard examination chair in the Otolaryngolgy clinic examination room. Topical anesthesia (lidocaine) is applied to one of the nasal passages and to the airway by breathing lidocaine in a mist. A flexible endoscope (camera) is passed through one of the nasal passages into the throat where additional lidocaine is applied to the larynx and trachea. Often there is some coughing at this point, which goes away in less than a minute. The camera is then passed through the vocal cords to the end of the trachea. Video images are taken during the examination to review with the patient at the end of the visit.


What can I expect after Transnasal Tracheoscopy?


Patients will have a numb throat for 45 minutes to an hour after the procedure. They should not have anything to eat or drink for one hour after the procedure to make sure they don’t aspirate (have food or liquid go down “the wrong pipe”). The nose can sometimes be a little sore after the procedure. Taking Tylenol should be sufficient to control any discomfort related to this.

Why should I have Transnasal Tracheoscopy at UW Health?

The Otolaryngologists have specialized training in disorders of the larynx and trachea. These specialists (Laryngologists) have extensive experience with TNT and other office procedures and use multiple relaxation techniques to make the procedure as fast, effective and comfortable as possible.


Having these procedures in the office permit the Laryngologists to obtain important information about the airway in a safe and effective way. Importantly performing TNT prevents evaluations in the operating room. Operations in the operating room carry additional risk to the patient, as well as time off of work and the need for others to devote time to taking care of them after surgery.