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Nasal Endoscopy - Uses, Complications, and Procedure

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Nasal endoscopy is a procedure used to observe the nose and sinus. Read the article to learn about the uses and procedures.

Written by

Dr. Saberitha

Medically reviewed by

Dr. Muhammad Shoyab

Published At October 10, 2022
Reviewed AtJanuary 22, 2024

Introduction

Nasal endoscopy is a technique used by medical professionals to visualize and operate the nasal structures and sinus passages associated with it. This technique is also called rhinoscopy. Large incisions are not required for nasal endoscopy. These special tools are used to diagnose problems in the nose. The flexible tube has a camera with a light on one end for a clear image. The screen is attached to the operating room. The images or video is displayed on the screen to carry out the surgical procedures in a precise manner.

What Are the Uses of Nasal Endoscopy?

  • Rhinosinusitis - The infection in the sinus and nasal passages causes inflammation. This condition is called rhinosinusitis. Endoscopy is used to visualize the sinus lining.

  • Headache - Frequent headaches and unusual pain near the face and cheeks due to fluid collection in the sinus are observed with a camera during the endoscopy.

  • Nasal Congestion - The inflammation of blood vessels in the nasal lining obstructs the nose. Endoscopy is used to identify the condition of nasal congestion.

  • Adenoids - The soft tissue enlargement behind the nasal opening is called adenoids. It can be visualized using endoscopy.

  • Epistaxis - People with a clotting disorder bleed easily. The chronic bleeding from the tiny blood vessels present in the nasal lining is called epistaxis. Endoscopy is used to localize the bleeding area.

  • Nasal Polyps - People with asthma and frequent allergies have small swellings in the nasal passages due to inflammation. These non-cancerous nodes are called nasal polyps. They are painless and can be examined in endoscopy.

  • Nasal Tumor - The cancerous growth in the nasal cavity is called a nasal tumor. Nasal endoscopy is helpful to the medical professional during the surgical removal of the tumor.

  • Cerebrospinal Fluid (CSF) - The space around the brain contains a fluid called cerebrospinal fluid. Any rupture to the connective tissue can leak the fluid into the head and cause severe headaches. This fluid is observed with nasal endoscopy.

  • Biopsy - Nasal endoscopy is used for biopsy. A separate tool is used to collect the tissue or mucus from the sinus. The nasal tissue is sent to the lab for biopsy results. The mucus is sent for a culture test to detect the growth of any bacteria or virus.

  • Foreign Objects - It is used to remove small objects like marble or coins from the nasal openings in children.

  • Anosmia - The condition in which the patient is unable to smell is called anosmia. The underlying cause of anosmia is identified and treated using nasal endoscopy.

  • Nasal Septal Defects - If there is any deviation in the nasal bridge, endoscopy is required to obtain pictures for repairing the septum during surgery.

  • Debris Removal - A suction is used along the endoscopy to remove the debris and clear the nose.

What Are the Complications Associated With Nasal Endoscopy?

The complications are rare in nasal endoscopy. Some of them are:

  • Excess nasal bleeding can occur in patients with a bleeding disorder or patients taking anticoagulants during nasal endoscopy.

  • The patient may be allergic to the anesthetic nasal spray.

  • Anxiety during nasal endoscopy procedures can cause fainting in the patient.

  • The risk of nasal endoscopy procedures depends on age factors and other systemic medical conditions.

  • In rare cases, the infection can spread and cause endocarditis in patients with heart disease. So patients with heart disease must give prior information to the medical professional.

How Is the Procedure Nasal Endoscopy Performed?

  • The blood thinners must be stopped for a few days before the nasal endoscopy procedure as per the advice of a medical professional.

  • Consume food and drink liquids at least one to two hours before the procedure because the anesthetic spray may give a feeling of nausea if the stomach is full.

  • The nose should be free from any congestion, so nasal decongestant spray is used before the procedure. It reduces the swellings in the nasal passages to allow the endoscope to pass easily inside the nasal cavity and sinus cavity. The anesthesia causes numbness in the nose. The anesthetic injection is rarely used in nasal endoscopy procedures.

  • The patient must sit in a chair with an erect spine. Once the numbness is achieved with the help of nasal spray, the nasal endoscopy is inserted into one side of the nasal passages.

  • The tube is pushed forward in a gentle motion. The test takes around three to five minutes.

  • The same process is repeated twice on the same side of nasal passages. Each time, the surgeon accesses different areas of the nasal cavity and sinus cavities.

  • The surgeon repeats the same procedure for the other nostril. If more visualization is needed, the surgeon repeats the procedure until a clear image of the nasal cavity is obtained.

  • The tissue for biopsy or mucus for culture test is removed after observing the tissue using endoscopy.

What Are the Disadvantages of Nasal Endoscopy Procedure?

  • Though the endoscope is a thin, flexible tube, it makes the patient uncomfortable due to the pressure created while inserting the tube.

  • The nasal spray takes around 20 to 30 minutes to wear off. The patient may feel numbness in the nostrils till the anesthesia wears off.

  • The patient is unable to sneeze or cough when the tube is inserted inside the nasal cavity.

  • The tube can irritate the connective tissue lining and cause inflammation in the nostrils.

Conclusion

After the procedure, the patient has to wait in the hospital for one to two hours for rest. The pressure created during tube insertion takes some time to heal but is not harmful. A soft diet can be consumed after nasal endoscopy to prevent vomiting. The blood-thinning medications must be continued after the procedure as per the advice of the healthcare provider. Biopsy results take a few days after the procedure. If the results are abnormal, the doctor will carry out the necessary treatment measures. Before taking the procedure, the patient must know the benefits and complications of nasal endoscopy.

Frequently Asked Questions

1.

What Instrument Used to Perform Nasal Endoscopy?

Nasal endoscopy is performed using an instrument called the nasal endoscope. It is a thin, rigid medical device consisting of fiber-optic cables that aid lighting. The device is connected to a source of light and a camera that displays the images on a computer screen.

2.

Is Nasal Endoscopy a Safe Procedure?

Nasal endoscopy is generally considered to be a safe procedure. However, the patients have been documented to experience fainting or bleeding of the nose after the procedure in some rare cases. Inform the doctor if it happens for the necessary medical intervention.

3.

Is Nasal Endoscopy Painful?

Nasal endoscopy is not a painful procedure. The procedure is done after spraying a nasal decongestant and an anesthetic drug. The effect of anesthetic causes a numbing effect. As a result, the patient will not experience pain. However, pressure or discomfort may be experienced as the device is inserted into the nose.

4.

Why is Nasal Endoscopy Done?

Nasal endoscopy is a diagnostic procedure used for various purposes like
- Detects the growth of a tumor.
- Identify a bleeding site.
- Identify a swelling inside the nose. It is also used for treatment purposes like retrieving an insect or foreign body from the nose

5.

What Is the Advantage of Nasal Endoscopy?

The advantages of nasal endoscopy are as follows:
- Nasal endoscopy is safer than conventional endoscopic techniques. 
- It is more comfortable compared to traditional techniques.
- Nasal endoscopy is comparatively cheaper compared to techniques like trans-esophageal echocardiogram.

6.

Is the Patient Awake During Nasal Endoscopy Procedure?

Nasal endoscopy is a simple procedure that is often done in an outpatient clinic. An anesthetic agent is usually sprayed to numb the nose before the procedure. But the patient can communicate and will be awake during the procedure.

7.

Does Nasal Endoscopy Cause Infection?

Nasal endoscopy, in rare cases, can cause infection if the devices are not re-processed properly after the procedure. However, the probability increases when the patient undergoes repeated such procedures that increase the chances of entry of infection-causing organisms into the body.

8.

Does Nasal Endoscopy Cause Headaches?

Patients have been reported to experience headaches after the nasal endoscopic procedure. If the headaches worsen or do not resolve over time, contact the physician immediately for the necessary attention.

9.

How Is Nasal Endoscopy Done?

The healthcare professional inserts the endoscope into the nose during the process. It is then passed through the nose and sinus tubes. Through the endoscope, the region can be seen in images. This can help with both the diagnosis and care of medical disorders.

10.

Can Nasal Endoscopy See the Throat?

Nasal endoscopy normally examines the inside and the back of the nose. However, it can also provide an image of the throat and the tongue. The doctor will examine the throat if it is necessary for the diagnosis.
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Dr. Muhammad Shoyab
Dr. Muhammad Shoyab

Radiodiagnosis

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