WHAT IS NASAL ENDOSCOPY?
Nasal endoscopy is a procedure to look at the nasal and sinus passages. The procedure is done with an endoscope. An endoscope is a tiny and flexible tube with a tiny camera and a little torchlight. An ENT (ear, nose, throat) doctor will carry out this procedure in his or her office. An ENT doctor is called an otolaryngologist.
During a nasal endoscopy procedure, your otolaryngologist inserts an endoscope into your nose and guides it through your sinus and nasal passages, viewing the images of the area the endoscope is examining. The procedure helps the ENT doctor to diagnose and treat different health conditions. Sometimes, the ENT doctor (also known as an otolaryngologist, as mentioned earlier) may use small tools to perform certain tasks like collecting tiny tissue samples.
TASKS AND INDICATIONS FOR A NASAL ENDOSCOPY. The indications or tasks of nasal endoscopy include the below:
- To identify disease in patients who are showing sino-nasal symptoms such as facial pressure or pain, mucopurulent (mucus and pus) drainage, decreased sense of smell, and nasal congestion or obstruction.
- To evaluate medical treatment response, such as secretions or pus, inflammation and mucosal edema or resolution of polyps after treatment with antibiotics, oral steroids, antihistamines, or topical nasal steroids.
- To evaluate patients with impending complications or complications of sinusitis.
- To evaluate unilateral diseases.
- Debriding and removal of mucus, crust, and fibrin from the blocked sinus and nasal cavities following functional endoscopic sinus surgery.
- To collect a purulent (pus) secretion culture.
- To evaluate the nasopharynx for the Eustachian tube problems, lymphoid hyperplasia, and nasal blockage.
The nasopharynx is the nasal part of the pharynx, lying behind the nose and above the level of the soft palate.
The eustachian tube is a tube that links the nasopharynx to the cavity of the middle ear to allow the equalization of the pressure on both sides of the eardrum.
- To evaluate the abnormal inability to use the sense of smell (this inability is known as anosmia) or the abnormally reduced ability to smell (called hyposmia).
- To evaluate cerebrospinal fluid leak (CSF).
- To evaluate potential pathology recurrence after functional endoscopic sinus surgery (FESS).
- To evaluate and treat nasal foreign bodies.
- To evaluate and treat nosebleed (epistaxis).
- To evaluate and take a biopsy of nasal lesions or masses.
SIDE EFFECTS OF A NASAL ENDOSCOPY
Nasal endoscopy is generally a safe procedure. However, some complications may not be ruled out, even if they may be rare. Such risks include the below:
- Harmful effects of decongestant or anesthetic.
While You Are Preparing For A Nasal Endoscopy;
Ask your doctor if you should stop taking any medicines, including blood thinners. Eat properly; drink normally and properly. Your otolaryngologist may give you more instructions on what you are to do before the test. Note that the procedure may take 15–45 minutes. You may return home the same day if other complicated conditions do not come up.
THE NASAL ENDOSCOPY PROCEDURE
Before The Test
Before agreeing to the test or procedure, make sure you know:
- The name of the test or procedure you are about to undergo.
- The reason behind the test.
- The results to expect, and what these results mean.
- The possible side effects or complications.
- When and where you are taking the test.
- The name and qualifications of your healthcare provider.
- What will happen if you do not have the test taken.
Preparing For The Procedure
Just before the procedure, a topical decongestant may be sprayed into your nose. This helps reduce swelling and lets the nasal endoscope pass easily through your nasal cavity and sinuses.
Your nose may also be sprayed with an anesthetic, which will briefly numb your nose. Your doctor may, of course, decide to avoid these medicines due to your health condition.
- You are to sit upright in an exam chair.
- After numbing the area, the doctor will insert the endoscope into one nostril.
- If you find the insertion uncomfortable, let your healthcare provider know, so he or she numbs the area the more, PR uses a smaller nasal endoscope.
- In one nostril, your doctor will push the endoscope forward to view a part of the nasal cavity and sinuses.
- The doctor may repeat this step thrice on the same side of your nose.
- Your doctor may then repeat this procedure on the other nostril and similarly repeat the step thrice, to obtain the needed information.
- If necessary, the doctor may remove a tissue sample for biopsy, after which the sample will be sent for further test.
After A Nasal Endoscopy
You should be able to go home that same day. Your doctor should provide specific instructions for you to take after the nasal endoscopy. Ask your doctor whether there are drugs for you to go home with and their prescriptions. Make sure to keep to every follow-up appointment. Avoid tobacco, alcohol, and caffeine. Eat a nutritional diet at regular times. Improve your lifestyle habits.
SUCCESS RATE OF NASAL ENDOSCOPY
The results after functional endoscopic sinus surgeries are good. Most research studies have reported 80%–90% rates of success. Good outcomes have also been obtained in patients who have had previous sinus surgeries.
The procedure is considered successful if the majority of patients’ symptoms have been resolved. Nasal obstruction and facial pain are most likely to be relieved, although post-natal drip often remains a challenge.
During the first basal endoscopy, 31 patients presented pale or darkened mucosa only in the middle or inferior turbinates. Among them, eight patients died (mortality rate= 25%). In contrast, 7 of the 12 patients who were presented with fungal disease in the lateral wall or nasal septum died (mortality rate= 58%; probability= 0.07).
It can be deduced, therefore, that with the low mortality associated with nasal endoscopy procedure, complications may arise as a result of underlying symptoms or health conditions associated with the nasal obstructed patient. These associated risks may result in a high mortality rate.
Can you die from nasal surgery?
Sinus or nasal surgery eliminates diseased or obstructive sinus tissue, resulting in improved sinus drainage. An internal medicine specialist from a leading hospital group in Dubai said that it was extremely rare for a patient to die due to sinus surgery.
How long does a nasal endoscopy take?
The test takes about 5–15 minutes. Your healthcare provider will spray your nose with a medicine (to reduce swelling and numb the area). He or she will insert the nasal endoscope into your nose for necessary diagnosis. This may be repeated about three times on each side of your nose (the nostrils) until the needed information is gotten. Sometimes, a tissue sample may be obtained for biopsy.
How much does a nasal endoscopy cost?
In some clinics, the cost of a nasal endoscopy (in office) ranges from $300 to $690. Those on high deductible health plans or without insurance can shop, compare prices and save. In Nigeria (or Africa as a whole), the bill may be much higher.
What diseases can be detected by an endoscopy?
Upper GI endoscopy can be used to identify many different diseases. Some of such are:
- Gastroesophageal reflux diseases.
- Cancers link.
- Inflammation or swelling.
- Celiac disease.
- Structures or narrowing of the esophagus.
- Precancerous abnormalities such as Barrett’s esophagus.
Barrett’s esophagus is an abnormal change (metaplasia) in the cells of the lower end of the esophagus, thought to be caused by damage from chronic acid exposure, or reflux esophagitis (the leaking of stomach acid up into, and the inflammation of, esophagus).
What does the ENT doctor do on the first visit?
Be sure to let the ENT know when the symptoms first began. Depending on the reasons for the visit, the ENT will perform a physical and visual examination. This may include looking in your eyes, nose, and throat. Your neck, throat, cheekbones, and other areas of your face and head may be palpitated.