A nasal endoscopy is a common, minimally invasive medical procedure used by ear, nose, and throat specialists to closely examine the internal structures of the nose and sinuses. This in-office examination allows a doctor to see areas of the nasal cavity that are impossible to view during a standard physical examination. The procedure uses an endoscope, which is a thin tube equipped with a light and a tiny camera. This instrument transmits magnified, high-quality images of the nasal passages to a screen, offering a detailed look at the condition of the tissues inside the nose.
Indications for Nasal Endoscopy
A physician recommends a nasal endoscopy when a patient presents with chronic or persistent sinonasal symptoms that require detailed visualization. This procedure is utilized to identify the source of long-standing nasal congestion, facial pressure, or pain. It offers a direct view to diagnose conditions such as chronic rhinosinusitis (inflammation of the nasal and sinus linings) and the presence of nasal polyps, which are non-cancerous growths.
The procedure is also important for investigating recurrent nosebleeds, allowing the doctor to pinpoint the exact location of the bleeding vessel. The endoscope serves a role in monitoring the effectiveness of medical treatments for known conditions, such as checking if polyps have shrunk after using topical steroid sprays. Furthermore, a nasal endoscopy is routinely performed after functional endoscopic sinus surgery (FESS) to clean out mucus, crusting, and debris, ensuring drainage pathways remain open during healing.
Patient Preparation Guidelines
Preparing for a nasal endoscopy is generally simple, requiring little change to your normal routine. It is important to communicate fully with your healthcare provider about any medications you are currently taking. You must notify the doctor if you are on any blood-thinning medication, such as warfarin or aspirin, as these may increase the risk of minor bleeding during the procedure.
You should also inform the clinic staff about any known allergies, especially to topical anesthetic agents, so they can use appropriate alternatives. A diagnostic nasal endoscopy typically does not require you to fast, meaning you can usually eat and drink as normal before your appointment. Taking these simple steps ensures the procedure is safe and the visual findings are clear and accurate.
Navigating the Examination Process
Upon entering the examination room, you will be seated comfortably in a specialized chair, often in an upright position, which helps the physician navigate the nasal passages. The first step involves preparing the inside of your nose to maximize visibility and minimize discomfort. The doctor will spray a combination of a topical decongestant (like oxymetazoline) and a local anesthetic (like lidocaine) into each nostril. The decongestant works rapidly to shrink blood vessels and reduce swelling of the nasal lining, creating more space for the endoscope to pass.
The anesthetic quickly numbs the nasal cavity; you may notice a bitter taste or a temporary sensation of numbness spreading to the back of your throat. This numbing is designed to reduce the feeling of pressure and prevent gagging during the insertion of the instrument. The endoscope itself is very slender, typically 3 to 4 millimeters in diameter.
The physician then gently inserts the lubricated endoscope into one nostril, carefully guiding it along the lower floor of the nasal cavity. As the scope advances, the doctor watches the magnified images on the monitor, systematically examining the mucosal lining, the nasal septum, and the turbinates, which are the scroll-shaped bones that regulate airflow. The doctor focuses particular attention on the sinus drainage pathways to look for signs of inflammation, pus, or obstruction. You will likely feel a sense of pressure as the endoscope moves deeper, especially as it passes through tighter spots, but this should not feel painful.
If a thorough examination requires it, the physician may make multiple passes with the scope, sometimes at different angles, to ensure all areas, including the openings to the sinuses, are clearly visualized. The entire process is quite fast, usually lasting only between one and five minutes per side. Throughout the examination, it is common to experience tearing from the eyes due to the stimulation of the nasal nerves, but this is a reflex and not a cause for concern.
Immediate Recovery and Aftercare
Immediately following the nasal endoscopy, you may experience minor, temporary side effects that are considered normal. The numbing sensation in your nose and throat will gradually wear off over the next 20 to 30 minutes. It is recommended to avoid eating or drinking until the numbness completely subsides to prevent accidental choking. You might feel mild soreness or irritation inside the nose, or have slight nasal congestion or minor spotting of blood for a short time.
You can typically resume your normal daily activities, including driving yourself home, right after the procedure is complete. To prevent irritating the nasal lining, avoid blowing your nose forcefully for a few hours. If you need to sneeze, try to do so with your mouth open to relieve pressure on the nasal passages. Contact your physician immediately if you experience heavy or persistent nasal bleeding, severe pain that does not improve, or signs of infection such as a fever.