A nasal endoscopy is a common, minimally invasive procedure used by ear, nose, and throat specialists to examine the internal structures of the nose and throat. The process involves inserting a thin, flexible or rigid tube, known as an endoscope, into the nostril. This specialized instrument is equipped with a light source and a tiny camera that projects magnified, high-resolution images onto a screen. This technique offers a detailed look at areas of the nasal passages not visible during a standard physical examination.
Defining the Endoscopic Route: Where the Scope Travels
The endoscope, which is typically very slender (2.7 to 4.0 millimeters in diameter), is guided gently along the floor of the nasal cavity. This initial path takes it past the inferior turbinate.
The scope then navigates deeper into the nasal passage, moving toward the posterior portion of the nose. It passes the middle turbinate to reach the middle meatus. This area is a major focus because it contains the ostia, the natural drainage openings for the maxillary, frontal, and anterior ethmoid sinuses, allowing the physician to assess for blockages or inflammation.
A key destination is the nasopharynx, the area at the back of the nasal cavity situated above the soft palate. Once there, the physician inspects the opening of the Eustachian tube, which connects the nose to the middle ear. In some cases, particularly with a flexible endoscope, the instrument may be advanced further down the throat to assess the larynx and vocal cords. The entire journey is relatively short, usually only a few inches into the nasal passage.
Conditions Diagnosed Using Nasal Endoscopy
The visual information provided by the endoscope helps diagnose many conditions affecting the upper respiratory tract. A common reason for the procedure is to evaluate chronic sinusitis, confirming the presence of pus or inflammation near the sinus drainage pathways. It is also used to identify the presence and extent of nasal polyps, non-cancerous growths that cause nasal obstruction and congestion.
The procedure is also used for several other diagnostic purposes:
- When a patient experiences recurrent or severe nosebleeds (epistaxis), allowing the physician to pinpoint the source of the bleeding.
- Evaluating unexplained nasal blockage or congestion that has not responded to initial medical treatments.
- Monitoring the healing process following functional endoscopic sinus surgery.
- Assessing the potential presence of masses or tumors within the nasal and sinus cavities.
Patient Preparation and Procedure Comfort
Patient comfort during the nasal endoscopy is prioritized through preparation steps taken before the examination. The first step involves spraying the inside of the nose with a topical decongestant medication. This spray shrinks the nasal lining and turbinate tissue, opening the nasal passages to allow the endoscope to pass more easily.
Following the decongestant, a local anesthetic spray is applied to numb the internal surfaces of the nose and the back of the throat. This agent quickly diminishes sensation, ensuring the procedure is tolerable. Patients commonly report feeling pressure or a slight tickling as the endoscope navigates the nasal structures. Since the numbing spray affects the throat, patients should avoid eating or drinking for about an hour after the procedure until sensation fully returns.