Endoscopy is a minimally invasive, diagnostic medical procedure. It is used to examine the interior surfaces of an organ or tissue, providing access to body cavities that are impossible to see using standard examination procedures. The nasal endoscope is a medical device consisting of a thin, rigid tube containing fiber-optic cables. The endoscope is connected to a light source and a video camera that can project magnified images onto a screen. These endoscopic images can be captured and recorded for documentation for each patient.
Because the endoscope is slender (only 2.7-4.0 mm in width), it may be passed through the nostril to examine the nasal passages, structures, and sinuses. While the traditional nasal examination with a speculum and a flashlight (called anterior rhinoscopy) allows a limited “keyhole” view of the front part of the nose, nasal endoscopy–with its superior light and magnification–provides a superior detailed look at the deeper internal nasal anatomy, central airway, and posterior aspects of the nose and sinuses. The various types of nasal endoscopes also provide for maximal visualization of the nasal and sinus cavities.
For example, the zero-degree nasal endoscope (also called rigid endoscope) allows a straight view from the tip of the instrument into the nose. The angled (30/45/70 degree) endoscopes, in which the view is at an angle from the tip of the endoscope, provide an around-the-corner view deep into the sinus cavities. The superior visualization capabilities enabled by nasal endoscopy have made it the go-to procedure for the diagnosis and management of nasal and sinus conditions.
Our in-office nasal endoscopy allows for a detailed examination of the nasal and sinus cavities. This procedure is currently the preferred method of evaluating medical issues such as nasal stuffiness and obstruction, sinusitis, nasal polyps, nasal tumors, and epistaxis (nose bleeds).
During the endoscopy, the patient is seated and the physician or other certified provider searches for the following: areas of swelling in the mucosal membranes, presence of purulent secretions (pus) draining from the sinus openings, enlargement of the nasal turbinates (internal nasal structures that humidify the nose), crookedness of the nasal septum (the wall that separates the two sides of your nose); presence of polyps; sites of nasal bleeding; and the presence of tumors within the nasal and sinus cavities. If pus is observed, it may be sampled with a small swab and cultured to determine what organism is causing the infection.
Typically, nasal endoscopy is performed with a 30-degree endoscope using the “three pass” technique, visualizing three main areas in the nasal and sinus cavities. In the first pass, the nasal floor and the nasopharynx are viewed. The endoscope is then removed and turned upwards and sideways in order to view the drainage areas of the nasal sinuses (the middle and superior meati and the sphenoethmoidal recess). In the third pass, the endoscope is used to view the roof of the nose and the area of the olfactory cleft (smell region).
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