Obviously both accomplish the same thing. As recently as 5-6 years ago it was always done through the nose, as that was the current technology. (Imagine long-term treatment this way and walking around the world with a tube out of your nose for months and months. As if everything else being done to you wasn't humiliating enough.) Techniques and products have improved and other alternatives to the nasal insertion are now available. The only reason to use the nasal tube these days is when the doctors believe that the tube is only going to be needed for a very short time, and they wish to avoid the minor surgery to place one through the stomach wall. I have heard that there are still some places that are not up to speed on the new/better stomach tubes and still use the nasal route for long term feeding, but most of these are outside the US.