What is endoscopy of the nasopharynx
Endoscopy is a diagnostic procedure that is performed on an outpatient basis or in a hospital setting. The examination of the nasopharynx by an endoscope involves taking biological material for bacteriological analysis, assessing the state of the mucosa, the presence or absence of neoplasms in the cavity. The procedure is carried out in different angles with the possibility to greatly enlarge the image, which makes it easier for the doctor to diagnose.
No preparation is required for endoscopic examination of the nasopharynx. This is absolutely painless manipulation, after which there is no rehabilitation period. The procedure lasts only a few minutes, after which the patient can immediately go home. Endoscopy ENT-organs among physicians is considered the least traumatic method of diagnosis. It is often used for surgical intervention on the nasopharynx.
Indications
More often endoscopy of the nasal cavity is carried out for diseases such as sinusitis, pharyngitis, frontalitis, angina, pollinosis, inflammation of the trellis labyrinth. Often an endoscopic examination is assigned to determine the extent of the spread of lymphoid tissue and a number of other diseases in order to clearly see the clinical picture. Indications for endoscopic examination include:
- injury or sensation of pressure in the face;
- olfaction impairment;
- impairment of vascular tone due to prolonged use of local vasodilators;
- curvature of the nasal septum;
- preoperative and postoperative diagnostics;
- shortness of breath;
- olfactory impairment, persistent discharge from the nasal cavity;
- frequent migraines;
- nasal bleeding;
- inflammation of the nasopharynx of different etiology;
- tinnitus, hearing impairment;
- snoring;
- speech development delay in a child;
- adenoiditis;
- etmoiditis;
- suspected of having a tumor.
Preparation of
Endoscopic examination of the nasopharynx does not require a special preparatory period. Often patients are nervous before the procedure due to fear of pain. In this case, the doctor can water the nasal mucosa with a local anesthetic. If minimally invasive surgery is performed, general anesthesia is used. In the broad nasal passages of the patient, the doctor makes an endoscope examination without the use of any anesthesia. Also, anesthesia is not used in cases of severe allergic reactions to anesthetics.
When an endoscopy is performed for a child, a conversation is conducted before the procedure. Parents or a doctor explain the following:
- with the assistance of a doctor examining the nose with an endoscope will take only a few minutes;
- if the baby does not jerk and break away, then the procedure will pass without pain.
For the painlessness of the procedure for a child, a gel with a lidocaine content is used. The preparation processes the flexible tip of the endoscope tube. When the anesthetic is affected, numbness of the nasal mucosa occurs, so that the tube enters the nasal passage imperceptibly for the baby. To numb the nasal passage doctor can use an anesthetic in the form of a spray.
How the endoscopy of
is done The nose examination with the endoscope is carried out in the sitting position. The chair in which the patient is seated, looks like a dental seat. With a slightly overturned head, the physician enters the vasoconstrictor into the nasopharynx to eliminate the excessive swelling of the mucous membrane. After the cavity is irrigated with a local solution of anesthetic. An anesthetic preparation can be a spray or solution in which a cotton swab is wetted.
After a while, anesthesia starts to act, which is manifested in the appearance of a mild tingling sensation on the nasal mucosa. At this stage, the endoscope is inserted, after which the doctor begins to study the condition of the nasopharyngeal cavity. The image is displayed on the computer monitor. For a more thorough examination, the doctor slowly holds the endoscope tube from the nasal cavity to the nasopharynx.
Endoscopy of the sinuses of the nose and nasopharyngeal cavity includes several stages:
- panoramic examination of the general nasal passage and the anterior of the nose;
- inspection of the mouths of the auditory tubes, the state of the nasopharynx arch, the posterior ends of the inferior nasal concha, the presence of adenoid vegetations;
- the device moves to the middle nasal concha, after which the condition of its mucosa and middle nasal passage is assessed;
- examines the upper nasal passage, the state of the outlets of the cells of the latticed labyrinth, the olfactory gap and the superior nasal concha.
The average procedure takes 5 to 15 minutes. If necessary, the diagnosis is supplemented by therapeutic or surgical manipulations( for example, removal of polyps).After the examination of the nasopharynx, the doctor prints out the images and draws up a conclusion. The results of endoscopy are given to the patient or sent to the attending physician. During examination of the nasopharynx, the expert evaluates:
- the presence of inflammatory processes or hypertrophy;
- color of mucosa;
- nature of secretions( clear, liquid, purulent, thick, mucous);
- the presence of anatomical disorders of the nasopharynx( curvature of the nasal septum, narrowing of the passageways, etc.);
- presence of tumor formations, polyps.
In the absence of poor health after the conclusion of the session, the patient goes home. If the endoscopy was supplemented by surgical manipulations( surgery, biopsy), then it is placed in the ward, where for a day is under the supervision of medical personnel. After the procedure, the patient is recommended to refrain from intense blowing for several days so that it does not provoke the development of nosebleeds.
Endoscopy of the nasopharynx for children
The procedure is standard diagnostics in ENT-practice. Its conduct for children and adults is not much different. In children's practice, in most cases, anterior rhinoscopy is performed, since the posterior technique is more complicated. If the child has hypertrophy of the palatine tonsils or mucosal edema, then difficulties during the endoscopy are not excluded.
Before starting the procedure, the doctor examines the nasopharynx cavity for ulcers or inflammatory processes. Anterior endoscopy is performed in two positions of the head - straight or thrown back. In the first case, it is possible to examine the anterior and posterior parts of the nasal cavity and septum. If the head is thrown back, then the middle sections of the nose and the nasal passage are examined. With a high qualification of the doctor, a child during endoscopic examination will not feel uncomfortable sensations.
For the back rinsoscopy the doctor uses a special spatula, which is pre-treated with an antiseptic solution. With its help, the front part of the tongue and the mirror inserted into the nasopharynx are moved away. Mirror surface is preheated, so that during the procedure it does not get fogged up. When detecting polyps or benign tumors, they are removed directly in the office of the otolaryngologist.
Endoscopy shows
The endoscopic examination of the nasopharynx is performed mainly for the diagnosis. If foreign objects in the maxillary sinus are detected, neoplasms of a benign or malignant nature, the doctor decides whether to perform an immediate surgical operation. With the help of endoscopy at the initial stage, it is possible to identify inflammatory processes accompanied by mucus, pus, redness, swelling, and other pathologies of the nasopharynx and maxillary sinuses, among them:
- adenoid tissue proliferation;
- pathology of the maxillary sinuses;
- polyps of different sizes;
- disturbed structure of the walls of the nasopharynx.
Contraindications
As a rule, endoscopic examination of the nasopharynx does not cause side effects or complications, so there are only two contraindications to the procedure: an allergy to a local anesthetic and a tendency to nosebleeds. If such conditions are present, then the patient should warn the doctor before the examination. With a tendency to bleeding, the doctor will carry out endoscopy with a thin device designed for examining children. The procedure is carried out with great care in excessively sensitive mucosa.
Sometimes ENT doctors do not resort to an examination of the nasopharynx by an endoscope with certain neurological disorders, so as not to provoke an attack in the patient. If no allergy has been reported, the occurrence of an allergic intolerance to the anesthetic during the procedure is accompanied by the following symptoms:
- swelling of the larynx and pharynx;
- hyperemia of the mucosa;
- increased body temperature;
- sensation of itching in the throat;
- lacrimation and sneezing;
- shortness of breath.
If you have allergy symptoms, the patient needs urgent help. The doctor should provide access to fresh air, unfasten clothes, inject an antihistamine intravenously. If the case is severe, then hormonotherapy is additionally carried out. After first aid, the patient is hospitalized in a hospital under the supervision of medical staff for several days.
Price
An endoscopic examination of the nasopharynx is performed by an otolaryngologist in the treatment room. Endoscopy is performed in medical centers or specialized clinics equipped with special equipment and licensed to conduct such services. The price of the procedure varies, depending on the location of the medical institution, the complexity of manipulation, the professionalism of the doctor and other factors. The average cost of endoscopic examination of the nasopharynx in Moscow medical centers:
| The name of the procedure | Price / rubles |
|---|---|
| Endoscopy of the nose | 1260 |
| Endoscopy of the nose and nasopharyngeal | 1450 |
| Endoscopy of the pharynx and larynx | 1600 |
| Endoscopy of the nasopharyngeal cavity | 1390 |
Video
Thanks to the development of modern medicine, endoscopic techniques have become one of the most informative methods of examination, which help the doctor to establish an accurate diagnosis. In otolaryngology, this method also appeared. Endoscopy of the nasal cavity and the upper part of the pharynx is performed when it is not enough simply to examine the nasopharynx of the patient with the help of mirrors to make an accurate diagnosis. Thanks to the endoscopic device, the doctor can in minute detail examine the interesting parts of the respiratory tract.
