Methods for examining patients are improved every year. A highly accurate way to diagnose diseases respiratory tract endoscopy of the nasopharynx is considered. The reliability of the results often depends on how competently the procedure is carried out and whether the parent can prepare the child for it.
What is nasopharyngeal endoscopy?
This procedure is prescribed for suspected inflammatory disease respiratory system, affecting the lower nasal cavity. Endoscopy of the nasopharynx allows you to see changes that have occurred in diseased organs, which increases the accuracy of the diagnosis.
During the procedure, the child is examined. This device resembles a long tube of small thickness (2–4 mm). A flashlight is located at the end of the device to increase visibility.
Next to the lighting device there is a camera that allows you to display the image on the monitor screen behind which the doctor sits. Tubes can be soft, very thin, hard or bendable. The device consists of several parts:
- frame;
- connection cable;
- working part;
- working end control handle;
- monitor;
- lighting cable;
- lighting cable connector;
- power cable connector;
- distal end.
Nasal endoscopy is absolutely painless. The procedure has high accuracy and allows you to see pathologies on early stages. This allows you to make a diagnosis with high accuracy.
Endoscopic examination is often combined with surgical procedures. This allows you to remove tumors quickly and least traumaticly. This operation leaves no marks on the face, and blood loss is minimal. The patient is sent home on the second day. This significantly reduces the number of days on sick leave.
Indications for use
Nasopharyngeal endoscopy is sometimes called rhinoscopy. It is carried out for diagnostic purposes and to remove certain tumors.
There are several diseases, the presence of which requires endoscopic examination:
- (inflammatory disease frontal sinus);
- (lesion of the ethmoid labyrinth);
- (pathology of the sphenoid sinus).
Nasal endoscopy is used to diagnose diseases and as therapy (in the treatment of polyps). But not only diseases are considered indications for endoscopic examination. These include some symptoms:
- decreased sensitivity of olfactory receptors;
- difficulty breathing;
- frequent nosebleeds;
- headache;
- increased amount of mucus discharge;
- feeling of pressure in the nose;
- sudden deterioration of hearing;
- the presence of nasopharyngeal diseases of inflammatory etiology;
- sensation or tinnitus;
- snore;
- delay speech development in children;
- in the anamnesis;
- injuries to the nose and skull;
- Preparation for rhinoplasty and monitoring the results obtained.
The presence of one of the symptoms gives rise to a nasal endoscopy. Sometimes the cause of nasopharyngeal diseases is a staphylococcus infection localized in another organ. Then respiratory tract diseases will only be complications of the underlying disease.
But with the help of endoscopic examination it is possible to see the smallest changes in the mucous membrane, which indicate the presence of inflammation. This helps prevent further spread of the infection and possible more serious complications.
Contraindications
Since endoscopy of the nasopharynx is painless and safe procedure, it does not have an extensive list of contraindications. But it cannot be performed if there is an allergic reaction to lidocaine. Since examination with an endoscope involves local anesthesia to exclude discomfort at the patient.
For children and patients with sensitive mucous membranes or frequent nosebleeds, special ultra-thin tubes of the device are used. This allows you to avoid nasopharyngeal injuries and carry out the procedure without complications.
What will endoscopy show?
An endoscopic examination allows you to look inside the nasopharynx and see its changes in more detail. Especially often during the procedure the following is revealed:
- injury to the nasopharyngeal mucosa;
- foreign bodies in the nasal cavity;
- pathologies of the paranasal sinuses;
- deviated nasal septum;
- neoplasms, including adenoids.
When performing an endoscopy of the nasopharynx, the doctor assesses the condition of the nasal mucosa and individual organ structures. The procedure allows for virtually no tissue trauma surgical interventions for the removal of tumors in the nasal cavity. This kind surgical treatment effective only on initial stages. In more advanced cases, endoscopy is not used.
Using an endoscope, the doctor determines the size of the tumor, the degree and rate of growth, and the extent of the lesion. When conducting a study, it is possible to consider the nature of the adenoids (purulent, mucous, mucopurulent), which helps to correctly choose treatment tactics.
Endoscopy allows us to identify the cause of hearing loss in children and the occurrence of speech problems. In such cases, the study is combined with tympanometry (diagnosis of the auditory tube).
Carrying out the procedure
Since the procedure is simple, it does not cause inconvenience due to local anesthesia and takes little time, it does not require special preparation. To conduct an endoscopy, it is necessary to mentally prepare the child for the fact that he will have to sit still for some time.
It is necessary to explain that this will not cause pain so that the baby is not afraid of the procedure. Otherwise, parents will have to hold and comfort the child after the examination is completed.
Before inserting the tube, its end is treated with lidocaine gel. Sometimes a special one is used, which is sprayed into the nasal cavity. The child reports the onset of the drug as a tingling sensation in the nose.
During the procedure, parents hold the child to prevent sudden movements and not accidentally injure the nasal mucosa. Sometimes the doctor shows the baby what he sees on the screen in order to distract and interest the little patient.
The procedure for diagnostic purposes does not take more than 20 minutes. There should be no discomfort or pain afterwards. Materials filmed during endoscopy can be given to the patient. Sometimes the patient is given only the doctor's report.
The success of the procedure largely depends on how the preparatory stage goes. The results of the study can also be influenced by the patient's condition during endoscopy. Therefore, sometimes you should refuse the procedure if the child is experiencing a lot of stress, and it is better to prepare him for the next visit to the specialist.
Video: Nasal endoscopy in children
Endoscopy is highly informative, painless, easy to use and safe diagnostic technique, allowing for examination of the upper respiratory tract. Applicable to patients without age restrictions.
One of its main advantages is the absence of exposure to electromagnetic waves.
Endoscopy allows:
- Monitor the treatment process;
- Track dynamics;
- Monitor the condition of the adenoids and nasal mucosa;
- If necessary, make adjustments to treatment.
- Detection of diseases at early stages;
- Wide diagnostic capabilities;
- Accurate determination of the stage of pathology;
- Identification of structural features of the organ;
- Reliability of diagnosis;
- Accurate assessment of treatment effectiveness.
Indications
The need for examination of ENT organs is determined by the doctor. Indications are signs of ENT diseases:
- Breathing disorders;
- Prolonged runny nose;
- Soreness in the ear or throat;
- Signs foreign body;
- Discharge;
- Hearing loss;
- Lack of sensitivity;
- Bleeding;
- Dry mucous membranes.
Advantages of the method
- Endoscopic examination allows you to see the condition of the organs of the ear, larynx, sinuses and nasopharynx with high magnification, make a diagnosis, start treatment immediately.
- Absent harmful effects, punctures and disorders of the mucous membrane.
- The brevity of the examination, the absence of the need to take many tests and conduct other types of diagnostics.
- Affordable price.
Endoscopic examination reveals:
- Deviation of the nasal septum;
- Sinusitis;
- Polyps;
- Adenoids;
- Laryngitis;
- Rhinitis; foreign bodies in the larynx and nose;
- Sinusitis;
- Pharyngitis.
Are there any contraindications?
Among the numerous methods for diagnosing diseases of the nose and throat special place Endoscopy of the nasopharynx takes place.
This examination method allows you to recognize the disease at the earliest stage of its onset and prescribe timely treatment.
Endoscopy of the nasal cavity and nasopharynx is performed using a device in the form of a thin tube - an endoscope. Thanks to the flexibility of the tube, the built-in mini-camera and a special flashlight, it is possible to conduct an effective examination for any ENT diseases.
Nasopharyngeal endoscopy: what is it?
Inspection using this technology is possible for both regular examination, and to clarify a previously made diagnosis. The diagnostic procedure can be carried out at different angles and magnifications, which guarantees the accuracy of the results.This type of diagnosis is low-traumatic. It is widely used in carrying out surgical operations in the nasopharynx area.
It does not require surgical incisions, lengthy preparation or recovery period. 
Endoscopic diagnosis of the nasopharynx– This is a painless procedure, lasting only a few minutes, causing minimal discomfort to patients. These advantages make it possible to recommend this manipulation to people of all ages, including children.
For what diseases is it prescribed? Indications for the procedure
This examination allows for a timely diagnosis various diseases. Among them are diseases such as tonsillitis, laryngitis, pharyngitis, sinusitis, sinusitis, tumors of various origins, polyps, pathologies of the mucous membranes, inflammatory processes in the maxillary sinuses. 
This type of diagnostics is used in parallel with more traditional ones, including
It is worth noting
Often, endoscopic examination of the nasopharynx becomes the only reliable way to assess the condition of hard-to-reach areas of the nasal cavity.
Indications for the use of the diagnostic procedure are:
- nasal breathing disorders and
- regular headaches of unknown origin;
- discharge of mucus, pus and blood from the nasal passages;
- hearing problems and speech underdevelopment in children;
- frequent occurrence of “noise” and congestion in the ears;
- feeling of pressure and hot flashes in the face.
Endoscopy is performed for snoring during sleep and to identify injuries to the nasal septum. Diagnostic procedure performed during preparation for surgery and in the postoperative period.
Contraindications to the procedure
There are no absolute contraindications to endoscopic examination. A certain obstacle to its implementation may be the presence of an allergy to anesthetics that are used to treat the nasal cavity before diagnostics.
Source: website Other contraindications include:
- availability of regular intensive
- weakened blood vessels;
- low level of blood clotting.
Increased sensitivity of mucous membranes, which is more common in children, should also not be a contraindication to endoscopy. In this case, an ultra-thin device is used, the use of which eliminates the risk of injury to the nasopharynx.
How to prepare for an endoscope examination?
Endoscopic examination of the nose does not imply any preliminary preparation. It is well tolerated by most patients and, as a rule, does not cause fear or discomfort even in young children. 
If a child is still afraid of a procedure unknown to him, it is necessary to mentally prepare him for the fact that examination with an endoscope will not cause pain. 
Practice shows that during the procedure children behave calmly and without fear. There is no need to make sudden movements or worry during the diagnosis. The body should be as relaxed as possible, and breathing should be even and calm.
Endoscopic examination of the nasopharynx: how is it done?
The endoscopic examination is carried out in several stages. Immediately before the manipulation, the nasal passages are cleaned and irrigated. This is necessary to reduce swelling of the mucous membrane and increase visibility. 
The gel is applied to the end of the tube. Under the influence of the anesthetic gel, the nasal passages become numb and their sensitivity decreases, thanks to which the doctor can freely insert an endoscope into the nose to determine the pathology.
During the examination, the patient sits in a chair with his head slightly tilted back. At the second stage, the doctor examines the vestibule of the nose for the presence of inflammation or purulent formations.
The nasal endoscope used during manipulation can be flexible or rigid. The examination results are displayed on the screen.
During the manipulation, the doctor receives visualization of the condition of the anterior sections of the nasal cavity, nasal passages, septum, and posterior walls. 
After the examination, the doctor removes the tube from the nasal cavity, prints out images of areas with pathological changes and makes a conclusion, the data of which is taken into account in further treatment.
How to perform an endoscopy on a child?
Many parents are distrustful of the procedure because they are not sure that their child will behave calmly. But in most cases anxiety in children who do not fully understand the significance of the procedure. 
Attention
The diameter of the tube used for children is no more than 3 mm. Shortened attachments are also used to diagnose diseases in children. An experienced doctor will need no more than 2-3 minutes to conduct a full examination.
With the help of endoscopic attachments, you can easily penetrate parts of the nose or pharynx that are inaccessible to the eye. Additional lighting and magnification allow for detailed examination pathological changes And anatomical features organs.
Hypertrophy and inflammation of the adenoids is a common pathology in children, which is very difficult to diagnose with the naked eye. Using an endoscope, the doctor can easily assess the condition of the adenoids and the presence or absence of fluid behind the membrane.
What can be detected using diagnostic endoscopy of the nasopharynx?
In addition to a clear diagnosis or confirmation of a preliminary diagnosis of diseases of the upper respiratory tract of various origins, endoscopy through the nose allows us to identify other, less common pathologies.
Young children very often stick various small objects into their noses while playing. In this case, the child experiences swelling of the mucous membranes, discharge of mucus and even pus from the nasal passages, which are difficult to explain. Endoscopy can easily detect the presence of foreign object in the nasal cavity.
Attention
If a patient is suspected of having malignant tumors, with help this method diagnostics can accurately determine the color of mucous membranes, the presence of stains or damage, and the thickness of tissue growth.
Pediatric nasopharyngeal endoscopy is also used to determine the causes of frequent nosebleeds and determine their type. Endoscopy is also invaluable in diagnosing the causes of hearing loss and lack of normal speech in preschool children.
Is the endoscopy procedure painful?
Many patients worry whether it hurts to do endoscopy of the nasopharynx. They are afraid of possible Negative consequences procedures.
In some cases, the following may occur:
- allergic reactions to local anesthetics;
- discomfort during its implementation and minor painful sensations in the nose for several hours afterwards;
- nosebleeds;
- dizziness.
If the procedure is performed in a reputable clinic with an experienced specialist, such complications occur very rarely. The painful syndrome is eliminated using local anesthesia. 
When the tube is inserted, the patient feels a slight pressure, which does not pose any danger. For children, flexible instruments are used that do not scratch or injure mucous membranes.
If the patient has a predisposition to frequent bleeding or he is taking coagulants, you must inform your doctor about these facts, as they can provoke nasal bleeding.
Where can I do a nasopharyngeal endoscopy for a child?
Which doctor performs this diagnosis? Typically, endoscopy is performed by an otolaryngologist in a procedure room. 
The examination is carried out in specialized clinics and medical centers equipped with modern equipment and licensed to provide this type of medical services.
Before an endoscopy, your doctor may order a blood test. This is necessary in order to eliminate the risk of allergic reactions to painkillers.
Endoscopy is the most modern and reliable method for diagnosing various pathological changes in the nasal cavity. Most patients adequately evaluate its effectiveness, speed, safety and reliability.
Carrying out the procedure on time allows for the treatment of various diseases without their transition to chronic forms and without complications.
Alternative names: fibro-rhinopharyngo-laryngoscopy, diagnostic endoscopy of the nasopharynx.
Endoscopy of the nasopharynx is one of the most modern methods examinations in ENT practice. The method consists of examining the structures of the nose and pharynx using special device– flexible fiberscope.
Endoscopy allows you to examine those structures of the nose that cannot be seen with direct rhinoscopy. The purpose of endoscopy is to identify pathological changes in the mucous membrane and other structures of the nasopharynx as early as possible. Early diagnosis allows in the future, if necessary, to carry out gentle interventions, during which the anatomical integrity of the structures of the nasopharynx is preserved if possible.
Indications
The basis for diagnostic endoscopy of the nasopharynx are the following diseases and conditions:
- pathological nasal discharge;
- recurrent nosebleeds;
- suspicion of tumor diseases pharynx and nasal cavity;
- sinusroethmoiditis;
Adenoid vegetations;
- hearing disorders caused by obstruction auditory tubes;
- headaches of unknown origin;
- pronounced violation nasal breathing.
Contraindications
There are no absolute contraindications to this procedure.
Preparation for the procedure
No special preparation is required. The physician should ask the patient for any allergic reactions, especially to local anesthetics. Immediately before the procedure, the patient should undergo a thorough toileting of the nasal cavity.
How is endoscopy of the nasopharynx performed?
First, anemization and anesthesia of the nasal mucosa are carried out, for which an anesthetic solution with a vasoconstrictor (adrenaline) is injected into the nasal passages.
A fiberscope, which is a thin tube with an optical fiber and a lens at the end, is inserted into the nasal cavity through the nasal passage. For children, fiberscopes with a diameter of no more than 2.4 mm are used, for adults they are slightly thicker - up to 4 mm. The endoscope gradually moves deeper into the nose under visual control; upon reaching the choanae, it is withdrawn into the pharyngeal cavity, where a thorough examination of its structures is carried out.
Inspection of the mucous membrane and structures of the nose is carried out through an eyepiece; the image can be displayed on the monitor screen. For a panoramic view, optics with a 70-degree view are used, and for a more thorough examination of structures, a 30-degree view is used.
Interpretation of results
First, the doctor examines panoramic structures of the nasal vestibule and the general nasal passage. The endoscope is then advanced towards the nasopharynx, and the condition of the inferior turbinate is assessed. The endoscope is advanced to the choanae, upon reaching which a visual assessment of the condition of the mouth of the Eustachian tubes is made, and the presence of vegetations is determined.
Endoscopy is performed separately for each nasal passage.
Additional Information
Endoscopy of the nasopharynx - the most convenient and highly informative method diagnosis of diseases of the ENT organs. Endoscopy allows you to refuse x-ray examination if you suspect, for example, adenoid vegetations, which allows you to reduce radiation exposure per patient.
Some of the disadvantages of endoscopy can be considered the invasiveness of the procedure, which sometimes makes it difficult to perform in children. However, in modern conditions It is possible to conduct endoscopic examination in children under sedation or anesthesia.
The procedure takes no more than 10-15 minutes, including preparatory stage. Endoscopy is performed in outpatient setting, and after its completion the patient can immediately go home.
Compared with rhinoscopy, endoscopy of the nasopharynx allows one to assess the condition of not only the nasal cavity, but also more deeply located structures, such as the choanae, the mouths of the auditory tubes, which undoubtedly increases diagnostic value research.
Literature:
- Otorhinolaryngology: a textbook for universities / V. T. Palchun, M. M. Magomedov, L. A. Luchikhin. - 2nd ed., rev. and additional - 2008. - 656 p. : ill.
- Likhachev A.G., Gladkov A.A., Ginzburg V.G. and others. Multi-volume guide to otorhinolaryngology. -M.: Medgiz, 1960.-T.1.-644 p.
This is a technique for examining the nose and nasopharynx, which is the least traumatic and does not cause stress or stress in the person being examined. mental trauma(this is especially important when it comes to examining a child). The need for an endoscopic examination arises in cases where examination with a nasal speculum is not enough for some reason.
What is endoscopy
Thanks to intensive development medical technologies endoscopic method
quickly became one of the survey standards. Endoscopy is a very informative method of visualizing the structures of the nasal cavity and nasopharynx, allowing one to assess their condition, appearance, the degree of severity of pathological processes identified during examination.
An endoscope is a small-diameter tube about half a centimeter thick. To perform endoscopy, a rigid (non-bending) or flexible (capable of changing direction) endoscope can be used. Inside the endoscope there is a lighting element and optical system; Such a device makes it possible to examine in detail even those that are inaccessible to direct inspection corners.
How is endoscopy done?
Preparation for manipulation
- Before inserting the endoscope, the nasal mucosa is irrigated with medication, causing vasoconstriction, as a result of which swelling is significantly reduced and the degree of visibility is increased. In addition, as a result, it becomes possible to insert the endoscope without practically touching the mucous membrane, which reduces the risk of injury.
- For the purpose of anesthesia, the mucous membrane is irrigated with any anesthetic. Important point: before using an anesthetic, you must make sure that the patient does not have negative reactions to it (for example, allergic).
Inspection
The patient is in a sitting position, with head thrown back, an endoscope is inserted into the nasal cavity. The procedure begins with an examination of the lower nasal passage, gradually advancing the endoscope to the nasopharynx and gradually examining all anatomical formations.
What is revealed during endoscopy?
This type of examination of the nasopharynx allows one to identify a number of processes without resorting to more traumatic examination methods, which is especially important when it comes to examination of the child.
Indications
Endoscopy provides an opportunity to examine inner surface nose and nasopharynx at different magnifications and from different viewing angles. This may be necessary for visual detection and diagnosis various pathologies, as well as removing foreign objects from the respiratory tract.
The reasons for carrying out this diagnostic procedure are:
- difficulty breathing;
- decreased sense of smell;
- presence of any nasal discharge;
- nose bleed;
- headaches (especially constant, intrusive ones);
- feeling of pressure in facial area;
- suspicion of inflammatory processes in the nasopharynx;
- complaints of hearing loss or extraneous sounds, tinnitus;
- V childhood- cases of speech delay;
- complaints of snoring;
- sinusitis (frontal sinusitis, sinusitis);
- hay fever;
- tonsillitis;
- injuries facial section skulls;
- suspicion of a foreign object entering the nasal cavity or nasopharynx;
- ethmoiditis.
Contraindications
The only one absolute contraindication for performing endoscopy of the nasopharynx is allergic reaction for an anesthetic used during endoscopy (lidocaine).
Caution must be exercised in cases where it becomes known that the patient has repeated nosebleeds.
Endoscopy of the nasopharynx in a child
Of no small importance in preparing for endoscopic examination in children is the moral preparation of the child for research. Although the procedure does not cause significant discomfort, the prospect of manipulating medical instruments may frighten a child. Therefore, before starting the procedure, the child should be properly prepared, explaining to him that nothing terrible is happening and it will not hurt him. If the child does not cry or resist during the examination, then the study will take place in a calm environment and will be more informative.
The most common reason to conduct an endoscopic examination of the nose and nasopharynx of a child - these are adenoids. Endoscopy of the nose for this pathology allows you to get the most complete picture (unlike an X-ray examination, which does not provide all the necessary information).
Using nasal endoscopy in a child with adenoids, it is possible to obtain the following information:
- presence and intensity inflammatory process on the nasal mucosa;
- presence and character pathological discharge on the surface of the adenoids;
- the presence and severity of edema on the mucous membrane of the nose, nasopharynx and adenoids;
- condition of the mouths of the auditory tubes.
Another case where endoscopy of the nose and nasopharynx can provide valuable information is when there is a suspicion of a foreign object in the nasal cavity or nasopharynx. In pediatric practice, these are usually small parts of toys. Endoscopic examination allows you to accurately determine the location of the foreign body and the condition of the mucous membrane at the site of its localization (the presence of edema or trauma).
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