Key Points • Transnasal Oesophagoscopy (TNO) is an approach to inspect the upper aerodigestive tract, especially in the head and neck cancer (HNCA) population that present with dysphagia. • Twenty-five (25) office-based TNO procedures were performed, with a same-day discharge rate of 96% (24/25) and no reported complications. • This case series is the first to compare preoperative and postoperative outcomes (EAT-10) following stricture dilatation using TNO in the UK. Our results show a statistically significant improvement in symptom severity (EAT-10 scores) (n=11, P=0.001). In the majority of these patients, strictures were due to post-radiation complications. Biopsy in 4/5 cases was sufficient for diagnosis/ruling out disease. Of these patients, 80% had a previous HNCA. • This study identifies the remit for a new ‘one-stop’ TNO service for suspected cancer referrals, of which a large proportion are patients with a previous HNCA. Surveillance, therapeutics and diagnostics can be achieved in a single visit. • Earlier staging or treatment may be achieved due to a fast turnover in clinic

Keypoints: • Implementing a one-stop Transnasal oesophagoscopy (TNO) service will benefit patients, clinicians as well as the NHS Trusts. • TNO is safe, well-tolerated and improves diagnostic and therapeutic precision in the upper aerodigestive tract and oesophagus. • The one-stop TNO service has clear financial benefits. • The one-stop TNO service is a streamlined pathway which improves patient care and experience. • Both the clinical and financial risk of introducing the service is low.