Otolaryngologists, commonly known as ENT doctors, specialize in the medical and surgical management of disorders affecting the ear, nose, throat, and related structures of the head and neck. Endoscopy is a diagnostic and therapeutic procedure involving the insertion of a thin, flexible, or rigid instrument (an endoscope) into a body cavity to visualize its interior. The endoscope is equipped with a light source and a camera, allowing the physician to view high-resolution images. Endoscopy is a routine tool in otolaryngology, providing a magnified view of areas that cannot be examined otherwise.
Endoscopic Procedures Within the ENT Scope of Practice
ENT specialists routinely perform several types of endoscopy tailored to the anatomy of the upper aerodigestive tract. Nasal endoscopy, also called rhinoscopy, involves inserting a thin scope through the nostril to inspect the nasal cavity and the openings of the paranasal sinuses. This quick, minimally invasive examination is often done in the office setting, sometimes using a rigid endoscope for superior magnification and image clarity.
Another common procedure is laryngoscopy, which focuses on visualizing the larynx (voice box), including the vocal cords. The scope, often a flexible nasopharyngoscope, is passed through the nose and down the throat to assess structures responsible for voice production and swallowing. This flexible instrument is also used for pharyngoscopy, which examines the throat, including the nasopharynx, oropharynx, and hypopharynx. These procedures grant the ENT direct access to complex, narrow passages.
Clinical Applications for ENT Endoscopies
Endoscopic procedures serve both diagnostic and therapeutic purposes for conditions affecting the head and neck. Diagnostically, nasal endoscopy evaluates chronic symptoms like persistent nasal congestion, facial pressure, and recurrent nosebleeds, identifying inflammation, structural abnormalities, or masses such as nasal polyps. Laryngoscopy is the standard method for investigating unexplained hoarseness, enabling detailed inspection of vocal cord movement and the detection of small lesions, nodules, or early-stage cancers.
Endoscopy also plays a significant role in treatment, particularly in the operating room. Functional Endoscopic Sinus Surgery (FESS) is a technique where the surgeon uses the endoscope to guide instruments, opening blocked sinus pathways to restore normal drainage. ENTs also use endoscopes to perform minor in-office procedures, such as precisely guided biopsies of suspicious tissue or the removal of foreign bodies lodged in the nose or ear canal.
Differentiating ENT Endoscopy from Other Medical Scopes
The term “endoscopy” is broad, but the ENT’s area of practice is anatomically distinct from other specialists who use similar instruments. ENT endoscopy focuses on the upper respiratory and upper alimentary systems: the ear, nose, sinuses, throat, and the entrance to the esophagus. This specialization contrasts with Gastroenterologists, who perform procedures like Esophagogastroduodenoscopy (EGD) to examine the stomach and small intestine, or colonoscopy to inspect the large bowel.
Pulmonologists also use endoscopes, primarily performing bronchoscopy to view the lower airways, trachea, and lungs. While the technology of a flexible tube with a camera is shared, the specific instruments, anatomical pathways, and diseases treated are unique to each medical specialty. The ENT’s expertise centers on the intricate network of the head and neck, contrasting with specialists who focus on the deeper gastrointestinal or lower respiratory systems.