A sinus scope examination, formally known as nasal endoscopy, is a common office procedure used by ear, nose, and throat (ENT) specialists. This examination uses a nasal endoscope, which is a slender, rigid or flexible tube equipped with a tiny camera and a light source. The endoscope provides a magnified view of the internal structures of the nasal passages and the openings to the sinuses. This detailed visualization is necessary because the standard physical examination cannot adequately access the deeper anatomy of this complex area.
The Purpose of Nasal Endoscopy
A physician performs nasal endoscopy to gain direct, magnified vision into the nasal and sinus cavities. This technique serves as an objective diagnostic tool for various conditions affecting the upper respiratory tract. It allows for the accurate assessment of the nasal mucosa, the sinonasal anatomy, and any pathology present in the region.
One primary use is the diagnosis and monitoring of chronic rhinosinusitis, involving persistent inflammation of the sinus linings. The scope can identify purulent secretions, mucosal edema, or anatomical blockages that impede proper sinus drainage. It is also instrumental in locating and evaluating nasal polyps, which are growths that can obstruct airflow and drainage pathways.
The procedure helps to pinpoint the source of frequent or severe nosebleeds by visualizing the bleeding vessel or lesion. It is used to investigate symptoms such as facial pain, a decreased sense of smell, or persistent nasal congestion. For patients who have undergone previous sinus surgery, the endoscope is used to monitor the healing process and ensure the surgical openings remain clear and functional.
Preparing for and Experiencing the Examination
Patient preparation for a nasal endoscopy is minimal, requiring no special fasting or restrictions. It is helpful to inform the physician of any medications, especially blood thinners, although stopping these is rarely necessary for this low-risk procedure. The examination is performed in the doctor’s office, with the patient seated upright.
The procedure begins with the application of topical medications to the nasal passages. A decongestant spray is used to shrink the nasal membranes, effectively opening the passages for better visualization. Following this, a numbing agent, such as topical lidocaine, is sprayed into the nose to minimize discomfort during the procedure.
Once the medications have taken effect, the physician gently inserts the endoscope into one nostril. Patients generally feel pressure or fullness, rather than pain, as the instrument is advanced. The doctor navigates the scope through the nasal cavity, examining anatomical landmarks like the septum, turbinates, and the ostia, which are the small openings leading to the sinuses.
The entire process is quick, usually taking between one and five minutes to examine both nasal passages. The camera projects the magnified images onto a screen, allowing the physician to inspect the tissues in real-time. If necessary, small instruments can be passed through the endoscope to collect a tissue sample (biopsy) or obtain a culture of any visible discharge.
Immediate Post-Procedure Care and Results
Following the examination, the patient can immediately return to their normal daily activities. The numbing spray may cause temporary numbness in the nose and sometimes the back of the throat, which wears off within 30 to 60 minutes. It is advisable to avoid eating or drinking until the throat sensation returns completely to prevent accidental aspiration.
Minor side effects are common but short-lived, including slight soreness in the nasal passages or a temporary nosebleed. Patients should avoid forcefully blowing their nose for several hours to minimize the risk of irritation or bleeding. If a sneeze occurs, it is best to let it out with an open mouth to reduce the pressure on the nasal tissues.
The results are often delivered immediately, as the physician views the internal structures during the examination. The doctor can discuss any findings, such as inflammation, polyps, or anatomical variations, right away to formulate a treatment plan. If a biopsy or culture was taken, the final diagnosis may require a follow-up appointment once laboratory results are available.