Introduction
Nasal endoscopy is a diagnostic procedure that involves the use of an endoscope, which is a flexible tube containing a tiny camera and a light. This procedure is typically performed by an otolaryngologist in their office to examine the nasal and sinus passages.
The sinuses are a set of spaces formed by the facial bones that connect to the nasal cavity, which is the air-filled area behind the nose. During the procedure, the healthcare provider will insert the endoscope into the nose and navigate it through the nasal and sinus passages. The images captured by the endoscope will aid in the diagnosis and treatment of various health conditions. Occasionally, small instruments may be used to collect tissue samples or perform other procedures.
What Are the Indications of the DNE Test?
Nasal endoscopy may be recommended by the healthcare provider to gather additional information about various problems, including:
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Nasal congestion.
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Nasal blockage.
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Nasal and sinus infections (rhinosinusitis).
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Nasal polyps.
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Nasal tumors.
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Nosebleeds.
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Loss of smell.
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Leaking of cerebrospinal fluid.
During a nasal endoscopy, a healthcare provider can identify specific details like the location of bleeding and swelling of nasal tissue. Additionally, it can aid in the diagnosis of cancerous growth. In certain situations, this procedure can be used as a treatment, such as removing foreign objects from a child's nose. Furthermore, a healthcare provider might recommend an endoscopy to evaluate the effectiveness of a nose or sinus treatment, like monitoring the reduction of nasal polyps.
Nasal endoscopy is commonly used to diagnose rhinosinusitis, which can cause symptoms like nasal blockage, discharge of yellow or greenish fluid from the nose, and facial pain. The healthcare provider may use the endoscope to examine the nasal passages for swelling and polyps and to collect pus from any infected areas to determine the cause of the infection and the best course of treatment.
A nasal endoscope can also be used by a healthcare provider to perform minimally invasive surgery in a hospital or surgery center. This type of surgery is suitable for treating conditions such as sinus infection, nasal polyps, and nasal tumors. Unlike traditional surgery, it involves using very small tools and does not require an external incision.
Is Diagnostic Nasal Endoscopy Painful?
It is important to note that diagnostic nasal endoscopy (DNE) is a relatively quick and painless procedure. Prior to the procedure, a numbing solution is applied to the inside of the nose to reduce any discomfort or pain. In some cases, the doctor may also place cotton soaked in an anesthetic and decongestant solution inside the nose. Although patients may experience a slight sting at the beginning, it typically only lasts for a few minutes before the nose becomes numb. Numbing the nose is not only for the patient's comfort but also helps to inhibit the natural sneeze reflex.
The decongestant solution serves to reduce the size of the nasal tissue, facilitating movement of the endoscope during the diagnostic nasal endoscopy (DNE). This improved mobility makes it more comfortable for the doctor to visualize all the nasal structures and ensures a thorough and comprehensive examination of the nasal cavity. DNE is generally performed with the patient either seated or lying down on a couch.
The diagnostic nasal endoscopy can be performed using either a rigid or a flexible endoscope, both of which are equally efficient. Once the doctor verifies that the numbing of the nose is complete, they will proceed with passing the endoscope from the front to the back of the nose, examining the septum that divides the right and left nostrils, as well as the turbinates', which are swellings inside the nose and play a role in sinus drainage.
What Are the Steps to Prepare for a Diagnostic Nasal Endoscopy?
There is no need for any special preparations before the diagnostic nasal endoscopy. A patient can simply arrive at the hospital without having to fast or avoid food and liquids. If a patient has conditions like diabetes, hypertension, or hypothyroidism, they can continue taking regular medication as usual. However, if they are a heart patient taking medications like Clopidogrel or Aspirin, they need to stop them at least 48 hours before the procedure.
A patient can also self-drive to the hospital for the procedure. In case they feel anxious about it, the doctor may prescribe an anxiolytic-like Alprazolam, which can be taken the day before and on the day of the procedure. It is recommended to bring a friend or family member with the patient to the hospital, as Alprazolam may cause some sedation.
What Are the Complications Associated With Diagnostic Nasal Endoscopy (DNE)?
DNE is considered a very safe procedure, especially in tertiary centers that handle high volumes of nose and sinus patients. Complications are rare and occur at a frequency of about one to two episodes per year. The most common complication is an allergic reaction to the numbing solution sprayed into the nose, which can cause sneezing, itching, redness in the nose and eyes, and tearing. If this occurs, the procedure may need to be stopped, but the allergic response can be easily managed.
Some patients may experience fainting or a vasovagal attack during the procedure, but this can be resolved quickly by making the patient regain consciousness, which is why the DNE is performed with the patient in a recliner chair or lying on a couch. Bleeding is also a potential complication, particularly in patients with bleeding disorders, which is why patients taking blood-thinning medications like Clopidogrel or Aspirin are advised to stop them at least 48 hours before the procedure. However, bleeding can also be easily controlled.
Conclusion
A diagnostic nasal endoscopy (DNE) is a safe and relatively painless procedure that involves the use of an endoscope to examine the nasal and sinus passages. It is typically performed by an otolaryngologist in their office to diagnose and treat various health conditions, such as nasal congestion, sinus infections, nasal polyps, nasal tumors, nosebleeds, loss of smell, and leaking of cerebrospinal fluid. The procedure can also be used to perform minimally invasive surgery. Patients do not need any special preparations before the procedure, but they should inform their healthcare provider of any blood-thinning medication they may be taking.
