Endoscopic examination of the nasopharynx in children. What is nasopharyngeal endoscopy and how is the examination performed? What can a nasal endoscopy reveal?

Indications and contraindications for endoscopy of the nose and nasopharynx

Indications

Contraindications

Clinical manifestations that the patient complains about and which are indications for endoscopy of the sinuses and nasopharynx are as follows:

    labored breathing;

    frequent snoring;

    dysfunction of the sense of smell;

    constant discharge from the nose and ears;

    hearing impairment;

    frequent nosebleeds;

    frequent headaches of unknown etiology;

    inflammatory diseases nose and nasopharynx;

    speech delays in children.

Diagnosis is mandatory for the following diseases:

    inflammation frontal sinus- frontal sinusitis;

    inflammatory processes of the ethmoid labyrinth;

    inflammation of the mucous membrane of the nasal stripe - rhinitis;

    Inflammatory processes of pathological overgrown palatine tonsil- adenoiditis;

    Inflammation of the mucous membrane of the pharynx - sore throat.

Indications also include previous facial injuries, as well as preparation for surgery and monitoring the results of treatment.

Contraindications to the procedure are minimal and relative. If the patient suffers from frequent bleeding from the nose, he needs to warn the doctor about this. He will perform the procedure using the thinnest endoscope used for nasopharyngeal endoscopy in children.

The method is also used with caution if the patient has an overly sensitive mucous membrane or has certain neurological disorders.

If the patient has an allergic reaction to products used for local anesthesia, those for which there is no individual intolerance are individually selected.

Preparation for endoscopy of the nose and nasopharynx

Endoscopy of the nasal cavity and nasopharynx does not require any preparation from the patient. As a rule, before it is carried out, the diagnostician talks about exactly how it will take place and answers all the patient’s questions. If the procedure is performed on a child, it is necessary for the parents to prepare him and tell him that during the process he needs to behave calmly and not move. If you experience any discomfort, you should immediately tell your doctor.

Before starting the manipulations, the patient is asked to take a sitting position and lean his head back on the armrest. In order to eliminate any discomfort, the nasal cavity is treated anesthetic in the form of a spray. Lidocaine gel is applied to the tip of the endoscope.

After the remedy has begun to act, the diagnostician begins to carefully insert the endoscope. In this case, an enlarged image is displayed on the screen and the doctor can examine it in detail. The examination lasts about twenty minutes, starting with the application of anesthesia and ending with writing a report.

If there are indications, endoscopy of the pharynx can be therapeutic. During its implementation, tumors can be removed, but only if the procedure does not lead to heavy bleeding or injury to the mucous membrane. The use of an endoscope eliminates unattractive scars on the face and minimizes the recovery period.

Endoscopy of the nasopharynx for children

Endoscopy performed on a child is no different from the procedure for adult patients. It is important to explain to the child how it will be carried out and how to behave while the doctor performs all the necessary manipulations. It is necessary for the child to understand that attempts to interfere with the doctor can lead to unpleasant consequences and extend the diagnostic time.

What does endoscopy of the nasopharynx show?

Most often, endoscopy is prescribed to clarify the diagnosis or determine the severity of the lesion. The procedure allows you to see:

This became possible due to the fact that the displayed image magnifies all the anatomical structures of the nasal cavity by thirty times.

Advantages of nasopharyngeal endoscopy at the Doctor Nearby clinic

We perform the procedure on both adult and young patients. Our specialists have modern endoscopes that make the procedure minimally uncomfortable. The process uses effective anesthetics, and our diagnosticians know how to find an approach to even the most capricious babies.

Content

Thanks to development modern medicine endoscopic techniques have become one of the most informative examination methods that help the doctor establish an accurate diagnosis. This method also appeared in otolaryngology. Endoscopy of the nasal cavity and upper pharynx is performed when accurate diagnosis It is not enough to simply examine the patient’s nasopharynx using mirrors. Thanks to an endoscopic device, the doctor can examine the parts of the respiratory tract of interest in great detail.

What is nasopharyngeal endoscopy

An endoscopic examination is a diagnostic procedure that is performed on an outpatient basis or in inpatient conditions. Examination of the nasopharynx with an endoscope involves taking biological material for bacteriological analysis, assessing the condition of the mucous membrane, the presence or absence of neoplasms in the cavity. The procedure is performed from various angles with the ability to greatly enlarge the image, which makes it easier for the doctor to make a diagnosis.

For endoscopic examination nasopharynx does not require any preparation. This is an 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 of ENT organs among doctors is considered the most minimally traumatic diagnostic method. It is often used for surgical intervention on the nasopharynx.

Indications

More often, endoscopy of the nasal cavity is performed for diseases such as sinusitis, pharyngitis, frontal sinusitis, tonsillitis, hay fever, and inflammation of the ethmoid labyrinth. Often endoscopic examination prescribed to determine the extent of spread lymphoid tissue and for a number of other diseases, in order to clearly see the clinical picture. Indications for endoscopic examination include:

  • injury or feeling of pressure in the face;
  • deterioration of sense of smell;
  • impaired vascular tone due to prolonged use of local vasodilators;
  • deviated nasal septum;
  • preoperative and postoperative diagnostics;
  • labored breathing;
  • deterioration of sense of smell, constant discharge from the nasal cavity;
  • frequent migraines;
  • nosebleeds;
  • inflammation of the nasopharynx of various etiologies;
  • tinnitus, hearing loss;
  • snore;
  • delay speech development The child has;
  • adenoiditis;
  • ethmoiditis;
  • suspicion of the presence of tumors.

Preparation

Endoscopic examination of the nasopharynx does not require a special preparatory period. Patients are often nervous before undergoing the procedure due to fear of pain. In this case, the doctor may irrigate the nasal mucosa with a local anesthetic. If minimally invasive surgery is performed, then it is used general anesthesia. If the patient's nasal passages are wide, the doctor examines the patient with an endoscope without using any anesthesia. Also, anesthesia is not used for severe allergic reactions to anesthetics.

When an endoscopy is performed on a child, a conversation is held before the procedure. Parents or a doctor explain the following points:

  • with the assistance of a doctor, examining the nose with an endoscope will take only a few minutes;
  • if the baby does not twitch and struggle, then the procedure will pass without pain.

To make the procedure painless for the child, a gel containing lidocaine is used. The flexible tip of the endoscope tube is treated with the drug. When exposed to an anesthetic, the nasal mucosa becomes numb, allowing the tube to enter the nasal passage unnoticed by the baby. A doctor may use an anesthetic spray to numb the nasal passage.

How is endoscopy done?

Examination of the nose with an endoscope is carried out in a sitting position. The chair in which the patient is seated is similar to a dentist's seat. With the head slightly thrown back, the doctor injects a vasoconstrictor into the nasopharynx to eliminate excessive swelling of the mucous membrane. Afterwards the cavity is irrigated local solution anesthetic. A spray or solution in which a cotton swab is moistened can be used as an anesthetic drug.

After some time, the anesthesia begins to take effect, which is reflected in the appearance of a slight tingling sensation on the nasal mucosa. At this stage, an endoscope is inserted, after which the doctor begins to examine the condition of the nasopharyngeal cavity. The image is displayed on the computer monitor. For a more thorough examination, the doctor slowly moves the endoscope tube from the nasal cavity to the nasopharynx.

Endoscopy of the sinuses and nasopharynx includes several stages:

  • panoramic examination of the general nasal passage and vestibule of the nose;
  • wellhead inspection auditory tubes, the condition of the nasopharyngeal vault, the posterior ends of the inferior concha, the presence of adenoid vegetations;
  • the device moves to the middle nasal concha, after which the condition of its mucosa and the middle nasal passage is assessed;
  • The upper nasal passage, the condition of the excretory openings of the ethmoidal labyrinth cells, the olfactory fissure and the superior nasal concha are examined.

On average, the procedure takes from 5 to 15 minutes. If necessary, diagnosis is supplemented with therapeutic or surgical procedures (for example, removal of polyps). After completing the examination of the nasopharynx, the doctor prints out the resulting images and draws up a conclusion. The endoscopy results are given to the patient or sent to the attending physician. During an examination of the nasopharynx, the specialist evaluates:

  • the presence of inflammatory processes or hypertrophy;
  • color of the mucous membrane;
  • the nature of the discharge (transparent, liquid, purulent, thick, mucous);
  • the presence of anatomical disorders of the nasopharynx (deviated nasal septum, narrowing of the passages, etc.);
  • presence tumor formations, polyps.

With absence feeling unwell After the session is completed, the patient goes home. If endoscopy was supplemented by surgical manipulations (surgery, biopsy), then he is placed in a ward, where he is under supervision throughout the day. medical personnel. After the procedure, the patient is advised to refrain from intensive nose blowing for several days so that it does not provoke the development of nosebleeds.

Endoscopy of the nasopharynx for children

The procedure is a standard diagnosis in ENT practice. Its implementation for children and adults is not much different. In pediatric practice, in most cases, anterior rhinoscopy is performed, since the posterior one is more complex in its technique. If a child has hypertrophy of the palatine tonsils or swelling of the mucous membrane, then difficulties during endoscopy cannot be ruled out.

Before starting the procedure, the doctor examines the nasopharynx cavity for the presence of ulcers or inflammatory processes. Anterior endoscopy is performed in two positions of the head - straight or tilted back. In the first case, it is possible to examine the anterior and posterior parts of the nasal cavity and the septum. If the head is tilted back, then the middle parts of the nose and the nasal passage are examined. If the doctor is highly qualified, the child will not feel any discomfort during an endoscopic examination.

To perform posterior rhinoscopy, the doctor uses a special spatula, which is pre-treated antiseptic solution. With its help, the front part of the tongue is moved back and a mirror is inserted into the nasopharynx. The mirror surface is preheated so that it does not fog up during the procedure. When polyps are detected or benign tumor they are removed directly in the otolaryngologist's office.

What does endoscopy show?

Examination of the nasopharynx with an endoscope is carried out mainly to make an accurate diagnosis. When found foreign objects V maxillary sinus, benign or malignant neoplasms, the doctor decides on immediate surgery. Using endoscopy initial stage You can identify inflammatory processes accompanied by mucus, pus, redness, swelling, and other pathologies of the nasopharynx and maxillary sinuses, including:

  • proliferation of adenoid tissue;
  • pathologies 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, therefore there are only two contraindications to the procedure: allergy to local anesthetic and a tendency to nosebleeds. If such conditions are present, the patient should notify the doctor before the examination. If you are prone to bleeding, the doctor will perform an endoscopy with a thin device designed for examining children. The procedure is performed with great care if the mucous membrane is overly sensitive.

Sometimes ENT doctors do not resort to examining the nasopharynx with an endoscope in case of certain neurological disorders, so as not to provoke an attack in the patient. If the presence of an allergy has not been declared, then the occurrence allergic intolerance anesthesia during the procedure is accompanied by the following symptoms:

  • swelling of the larynx and pharynx;
  • hyperemia of the mucous membrane;
  • increased body temperature;
  • itchy feeling in the throat;
  • watery eyes and sneezing;
  • labored breathing.

If signs of allergy appear, the patient must urgent help. The doctor must provide access fresh air, unbutton clothes, administer intravenously antihistamine. If the case is severe, then additional hormone therapy is performed. After first aid is provided, 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 treatment room. Endoscopy is performed in medical centers or specialized clinics equipped with special equipment and licensed to provide such services. The price of the procedure varies depending on the region where the medical institution is located, the complexity of the procedure, the professionalism of the doctor and other factors. average cost endoscopic examination of the nasopharynx in medical centers in Moscow:

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Endoscopy is a modern, informative and painless method for diagnosing diseases of the nasopharynx, which allows us to examine hard-to-reach areas of the nasopharynx that are not visible during a standard examination.

Contraindications:

  • allergic reactions to the anesthetic used;
  • with caution if you are prone to nosebleeds;
  • problems with blood clotting;
  • neurotic disorders.

Equipment used:

  • rigid endoscope;
  • light source for endoscopic examination of ENT organs;
  • ENT processor ATMOS S 61.

None modern examination ENT organs cannot do without endoscopic examination. Endoscopy of the nasopharynx in Moscow is one of the most advanced and safe ways examinations in ENT practice. With this procedure, the doctor will be able to examine the ENT organs and look into those parts of the nasopharynx that are not visible to the human eye during a routine examination. Endoscopic examination helps to identify pathology of the nasopharyngeal mucosa at an early stage and, accordingly, carry out the necessary therapeutic procedures in a timely manner.

Nasopharyngeal endoscopy for adults can be done in any ENT clinic or medical institution that has an ENT office equipped with an endoscopic unit.

This diagnostic method is very popular and is used for many diseases of the ear, nose and throat. Endoscopy is indicated for frequent nosebleeds, nasal pain, headaches, impaired nasal breathing, sense of smell, adenoids and snoring. With the help of endoscopic examination, inflammation in the nasopharynx and sinuses can be detected. An experienced ENT doctor will use the procedure to “see” enlarged adenoids, which are often found in children, polyps and tumors.

Our doctors

How the research works

To perform endoscopy, a special instrument is used - an endoscope. It resembles a flexible tube 4 mm in diameter for an adult. For a child, a thinner instrument is used - 2 mm. A camera and a light source are built into the tube, and an eyepiece is at the other end of the tube. What the doctor sees with an endoscope inside the nasopharynx can be displayed on a screen using a camera.

The whole procedure takes no more than 2 minutes and proceeds according to the following scenario:

  • so that the patient does not have painful sensations, the ENT doctor uses an anesthetic (usually lidocaine);
  • the patient sits comfortably in a chair with his head thrown back a little (almost like at a dentist appointment);
  • the doctor carefully inserts the instrument into the nasal passage, and immediately after the procedure clinical picture becomes clear.

There are no absolute contraindications to endoscopy. If the nasal mucosa is prone to bleeding, you have poor blood clotting or an allergy to lidocaine, be sure to tell your ENT specialist about this.

How much does the procedure cost?

The price in Moscow for nasopharyngeal endoscopy for adults depends on the pricing policy of the clinic and the status of the medical institution. Of course, every patient strives to do endoscopic diagnostics at the right price. In our clinic, the cost of the study has remained unchanged for several years now. Considering the economic situation, our price list has not changed for three years, and the quality of service remains at the highest level.

Endoscopic examination is performed by ENT specialists with extensive experience. Experience of the chief physician of the clinic V.M. Zaitsev for more than 19 years. The procedure is painless, non-traumatic and as comfortable as possible for the patient.

The price of nasopharyngeal endoscopy performed in our clinic in Moscow is 2,500 rubles. A video endoscopy procedure is also available. The difference between this procedure and the standard one is the ability to connect a camera and record the nasal cavity for submission to the hospital. During the examination, our ENT doctor will show on the screen and comment on everything he sees, talk about the causes of the disease and possible methods treatment.

In this way, a trusting relationship with the patient is formed, and the patient realizes that there is nothing terrible in the manipulations being performed. The cost of video endoscopy is 3000 rubles.

Certificates and licenses

You can make an appointment for an endoscopic examination by calling the clinic’s reception desk or using a special appointment form on the main page of the website. We will select for you convenient time. Please, come. We will be happy to help you!

For getting complete information endoscopy is often prescribed in otolaryngology to determine the patient’s health status. The diagnostic procedure consists of a visual examination of the cavity internal organs without the use of special mirrors, x-rays, ultrasound or magnetic resonance radiation.

When nasopharyngeal endoscopy is prescribed, patients have many questions. Most of them are associated with the fear of experiencing pain during the diagnosis.

What is nasal endoscopy and does it hurt?

Nasal endoscopy is performed with a device that is a tube not exceeding 4 mm in diameter. The tube can be flexible or rigid. The device is equipped with a camera and a lighting element. With its help you can examine the mucous membrane from different angles. If necessary, the doctor can zoom in and examine the area being examined in detail.

Diagnostics belongs to the category of minimally invasive procedures. During the examination, the patient does not experience pain syndrome. Endoscopy of the nasopharynx for children and adults is performed using local anesthetics. After the study there may appear discomfort which go away within a few hours.

Diagnostics makes it possible to assess the condition of not only the nasal cavity, but also more deeply located structures, such as choanae, orifices of the auditory tubes, which increases the value of the study in comparison with other procedures.

As a result of endoscopy, the patient may experience bleeding. Such by-effect happens rarely. The most common cause is a predisposition to nasal bleeding or the use of anticoagulants.

Indications and contraindications for the study

  • snore;
  • frequent sinusitis;
  • decreased sense of smell;
  • discharge of pus from the nasal passages;
  • impaired hearing acuity;
  • delayed speech development in children;
  • noise in ears;
  • deviated nasal septum;
  • nasal injuries;
  • frequent headaches of unknown etiology;
  • inflammatory processes in the nasal sinuses;
  • sore throat, pharyngitis, rhinitis, etc.

Examination of the mucous membranes using an endoscope is often prescribed before surgical intervention or after surgery (to control the quality of treatment). An indication for diagnosis may be to determine the cause of difficulty in nasal breathing when other research methods do not bring the desired results.

Nasal endoscopy has a number of relative contraindications. The study is not recommended if the patient:

  • hemophilia;
  • regular and intense nasal bleeding;
  • thinning of vascular walls.

To avoid the possibility of complications, people with a tendency to nasal bleeding are recommended to conduct research using a thin tube, i.e. pediatric endoscope.

How to prepare for research?

Endoscopy, or fiberoscopy of ENT organs, does not require special preparatory procedures. The doctor must tell you how the study will take place and what sensations the patient will experience at this moment.

Since endoscopy is performed using local anesthesia, before diagnosis it is necessary to check for the presence or absence of an allergic reaction to the anesthetic drug. When positive result another test is selected medicine, which does not cause an immune response in the body.

Endoscopic examination of the nasopharynx in children is carried out in the presence of an adult (parents or guardian). If the child is small, it is recommended to hold him in your arms.

How is endoscopy of ENT organs performed?

An endoscopic examination of the ENT organs is carried out by an otolaryngologist. The patient is seated on a special chair with a headrest. So that nothing interferes with the examination, the doctor clears the nasopharynx of mucus. To relieve excessive swelling, the cavity is treated with a vasoconstrictor and then with an anesthetic. The effect of the anesthetic on mucous tissues is initially accompanied by a slight tingling or burning sensation. The tip of the endoscope is also treated with an anesthetic gel.

When the painkiller begins to take effect, the doctor begins to examine the mucous membrane. He inserts an endoscope into the nasal cavity and slowly moves it across the area being examined. At this point, the patient experiences pressure, but not pain. If necessary, the otolaryngologist may ask you to change the position of your head.

Modern video endoscopic equipment transmits an image of the area being examined onto a monitor. The diagnosis is also video recorded. Since the device displays an image on the screen, several specialists can simultaneously take part in examining the patient.

During the examination, biological samples may be taken from the patient for additional tests.

When the assessment of the condition of the mucous membrane is completed, the doctor carefully removes the tube from the nasopharynx. The entire diagnostic process takes 20-25 minutes. At the end of the study, the doctor prints out images of the pathological areas.

Fibroscopy of the nasopharynx does not require hospitalization of the patient. If no complications arise during the diagnostic process, the person can go home immediately after the examination.

Interpretation of diagnostic results

Video endoscopy of ENT organs, thanks to the image recording function, provides photo and video materials that allow them to continue to be used for diagnostic and therapeutic purposes.

Decoding the results makes it possible to determine the reason that became the indication for the examination. The condition of the mucous membrane is assessed (its color, presence of spots, thickening, inflammation, etc.). Endoscopy can detect abnormalities anatomical structure. Based on the examination results, the patient can be diagnosed with the following pathological processes:

  • tissue atrophy;
  • adenoids;
  • polyps;
  • Availability foreign bodies in the nasal passages;
  • benign and malignant neoplasms;
  • atresia;
  • perforation of partitions;
  • infectious diseases, etc.

Nasal endoscopy may be performed at the same time as treatment. For example, if during the diagnostic process it was determined that the cause of swelling of the mucous membrane and the appearance of nasal discharge in a child was a small toy, it is removed from the nasal passages during the examination.

Although endoscopy is informative method diagnosis, its results may not be sufficient to make a final diagnosis. For example, if a tumor was discovered in the patient’s nasopharynx, additional histological examination of the tissues is necessary. This analysis allows us to detect the absence or presence of cancer cells.

Often diseases that arise in the nasopharyngeal region, in the absence of timely treatment contribute to the emergence of a number of complications. For example, advanced sinusitis threatens patients with otitis media, sore throat, and cardiac myocardium and chronic nasal congestion.

In order to identify physiological problems of this kind, specialists medical institutions X-ray and rhinoscopy are actively used. But special place Among similar diagnostic methods, nasopharyngeal endoscopy ranks. The main aspects of this procedure are discussed in detail in this article.

Indications for examination

Diagnosis of the nasal cavities and some part of the throat is carried out if a person has characteristic respiratory diseases symptoms:

Endoscopy is often included in preparatory stage rhinoplasty

If small child If there is no corresponding level of speech development, a specialist will most likely prescribe an endoscopic examination of the nasopharynx in order to exclude problems with the ENT organs. Long-term use medical supplies, intended to dilate the nasal vessels, causes their weakening and destruction. Such a case is also an indication for the procedure.

The most important reason for undergoing the study remains inflammatory process nasopharyngeal part.

Carrying out the procedure

The examination is carried out using an endoscope - medical instrument, which looks like a small hand-held remote control connected to a long thin tube equal to 2–4 mm. At its end there is a camera and a microphone. They help the doctor examine the mucous membranes in detail through the eyepiece. The image is transmitted to a monitor for better visualization of anatomical structures.

The procedure begins with local anesthesia, which takes effect approximately 8-12 minutes after application. The patient should take a comfortable position on the couch. To do this, you will need to slightly tilt your head towards the back of the chair and try to relax.

Then the specialist carefully introduces the disinfected most narrow part endoscope into the nose through the nostrils one by one, examining the condition of the nasopharynx and auditory tubes. This stage usually takes no more than 5–8 minutes.

If during the examination significant deviations from the norm are revealed, then the specialist can carry out parallel medical manipulation, for example, a biopsy. The features of nasopharyngeal endoscopy for a child are described in this article.

Contraindications

Since diagnostics such as endoscopy are considered absolutely safe, painless and non-invasive, the list of contraindications comes down to only 4 points:

  • allergies to painkillers Novocaine and Lidocaine (sometimes the session is carried out without anesthetics if the nasal passages are quite wide);
  • hemophilia or other diseases characterized by low blood clotting;
  • heavy neurological abnormalities that cause uncontrolled body movements;
  • underdeveloped nasal vascular network.

How to prepare properly

Nasal endoscopy does not suggest special training. The only thing worth working on is fear. You can get rid of it by watching reviews, articles and videos about the procedure. It is not advisable to get rid of signs of swelling at home before going out. diagnostic center. If there is nasal congestion, then the doctor will independently use a special vasoconstrictor in the form of a spray.

What can be revealed with an endoscope

Thanks to the improvement of the latest models of laryngoendoscopes, it has become possible to diagnose multiple ailments, especially inflammation:

  • mucous membranes – rhinitis;
  • frontal sinus - frontal sinusitis;
  • paranasal sinuses – sinusitis;
  • sphenoid sinus – sphenoiditis;
  • palatine tonsils – tonsillitis;
  • ethmoid labyrinth (cells of the ethmoid bone of the nose) – ethmoiditis;
  • lymphoid tissues of the pharynx - pharyngitis;
  • maxillary sinuses – sinusitis;
  • pharyngeal tonsil – adenoiditis.

Among other things, endoscopy of the nose, throat and ear canals allows you to identify congenital or acquired structural anomalies, such as a closed curvature of the nasal septum.


A specialist using an endoscope can also detect hay fever - allergic reaction on pollen particles plant origin

Price

Price for diagnostic procedure pharynx and nasal sinuses directly depends on where the diagnosis is made. Medical centers and clinics in various regions of Russia charge about 800–2400 rubles for the service in question. If you need to conduct a video endoscopy, which involves handing over a disk with the results to the patient, then you will have to pay a little more - 2600–3500 rubles per session.

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