What is endoscopy of the nasopharynx and how is the examination performed. Endoscopy of the nose and nasopharynx in a child - what does this study give? Endoscopy of the nasopharynx

To receive complete information about the state of health of the patient in otolaryngology, endoscopy is often prescribed. The diagnostic procedure consists in a visual examination of the cavity internal organs without the use of special mirrors, x-rays, ultrasound or magnetic resonance radiation.

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

What is a nasal endoscopy and does it hurt?

Nasal endoscopy is performed with a device, which 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 it, you can examine the mucous membrane from different angles. If necessary, the doctor can enlarge and examine the area under study 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 research, there may be discomfort that pass within a few hours.

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

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

Indications and contraindications for the study

• snore;
• frequent sinusitis;
• decreased sense of smell;
• discharge of pus from the nasal passages;
• hearing loss;
• delayed speech development in children;
• noise in ears;
• curvature of the nasal septum;
• nose injury;
• frequent headaches of unknown etiology;
• inflammatory processes in the sinuses;
• angina, pharyngitis, rhinitis, etc.

Inspection of the mucous membranes with an endoscope is often prescribed before surgical intervention or after surgery (for the purpose of quality control of treatment). An indication for diagnosis may be to find out the cause of difficult 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 the vascular walls.

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

How to prepare for research?

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

Because endoscopy is performed using local anesthesia, before diagnosis, it is necessary to check the presence or absence of an allergic reaction to an anesthetic drug. When positive result the test is selected another medication, which does not cause an immune reaction of 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 ENT endoscopy performed?

Endoscopic examination of the ENT organs is performed by an otolaryngologist. The patient is seated in a special chair with a headrest. So that nothing interferes with the examination, the doctor clears the nasopharynx of mucus. To remove excessive swelling, the cavity is processed vasoconstrictor drug and then an anesthetic. The action of an 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 act, the doctor proceeds to examine the mucosa. He inserts an endoscope into the nasal cavity and slowly advances it over the area under study. At this point, the patient experiences pressure, but not pain. If necessary, the otolaryngologist may ask to change the position of the head.

Modern video endoscopic equipment transmits the image of the area under study to the monitor. There is also a video recording of the diagnostics. Since the device displays a picture on the screen, several specialists can simultaneously take part in the examination of the patient at once.

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

When the evaluation of the mucosal condition 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 pictures of the pathological areas.

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

Interpretation of diagnostic results

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

Deciphering the results makes it possible to determine the reason that became an indication for the examination. The condition of the mucosa is assessed (its color, the presence of spots, thickenings, inflammation, etc.). Endoscopy can detect abnormalities anatomical structure. According to the results of the examination, the patient can be diagnosed with the following pathological processes:

• tissue atrophy;
• adenoids;
• polyps;
• the presence of 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 found that a small toy became the cause of swelling of the mucous membrane and the appearance of discharge from the nose in a child, it is removed from the nasal passages during the examination.

Although endoscopy is informative method diagnosis, its results may not be enough to make a definitive diagnosis. For example, if a tumor was found in a patient in the nasopharyngeal region, an additional histological examination fabrics. This analysis reveals the absence or presence of cancer cells.

This is a technique for examining the nose and nasopharynx, which is the least traumatic and does not cause stress or mental trauma in the examined person (this is especially important when we are talking about examining the child). The need for endoscopic examination arises in cases where examination with a nasal mirror for some reason is not enough.

What is endoscopy

Due to the intensive development of 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 to assess their condition, appearance, the degree of severity of pathological processes identified during the examination.

An endoscope is a small tube about half a centimeter thick. A rigid (non-flexible) or flexible (can change direction) endoscope can be used for endoscopy. Inside the endoscope there is an illuminating element and optical system ; such a device makes it possible to examine in detail even inaccessible to direct inspection corners.

How is an endoscopy done?

Preparation for manipulation

1. Before the introduction of the endoscope, the mucous membrane of the nasal cavity is irrigated with a medication, causing vasoconstriction, as a result of which edema is significantly reduced and the degree of visibility increases. In addition, as a result, it becomes possible to insert the endoscope without touching the mucous membrane, which reduces the risk of injury.
2. For the purpose of anesthesia, the mucous membrane is irrigated with any anesthetic. An 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 in a sitting position head thrown back, enter into nasal cavity endoscope. 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 you 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

With the help of endoscopy, it is possible to examine the inner surface of the nose and nasopharynx at various magnifications and from different angles of view. This may be necessary for visual detection and diagnosis various pathologies, as well as extracting from respiratory tract foreign objects.

The reasons for this diagnostic manipulation are:

• difficulty in breathing;
• decreased sense of smell;
• the presence of any discharge from the nose;
• nose bleed;
• headaches (especially persistent, obsessive);
• feeling of pressure in facial area;
• suspicion of inflammatory processes in the nasopharynx;
• complaints of hearing loss or extraneous sounds, tinnitus;
• in childhood- cases of speech delay;
• snoring complaints;
• sinusitis (frontal sinusitis);
• hay fever;
• tonsillitis;
• injuries of the facial part of the skull;
• suspicion of a foreign object entering the nasal cavity or nasopharynx;
• ethmoiditis.

Contraindications

the only absolute contraindication for nasopharyngeal endoscopy is allergic reaction an anesthetic used during endoscopy (lidocaine).

Caution must be observed in cases where it becomes known about repeated nosebleeds in a patient.

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 the study. Although the procedure does not cause significant discomfort, the prospect of manipulating medical instruments can be frightening for a child. Therefore, before starting the procedure, the child should be properly prepared, explaining to him that nothing terrible is happening, and he will not be hurt. If the child does not cry or resist during the examination, then study will take place in a relaxed environment and will be more informative.

The most common cause for endoscopic examination of the nose and nasopharynx for a child, these are adenoids. Nasal endoscopy in this pathology allows you to get the most complete picture (unlike x-ray examination, which does not provide all the necessary information).

With the help of nasal endoscopy in a child with adenoids, it is possible to obtain the following information:

• the presence and intensity of the 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 nasal mucosa, 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 the suspicion of a foreign object in the nasal cavity or nasopharynx. In pediatric practice, these are, as a rule, small parts of toys. Endoscopic examination allows precise location foreign body and the condition of the mucous membrane at the site of its localization (the presence of edema or trauma).

Often diseases that have arisen in the nasopharyngeal region, in the absence of timely treatment lead to a number of complications. For example, running sinusitis threatens patients with otitis media, tonsillitis, lesions cardiac myocardium and chronic nasal congestion.

In order to identify physiological problems of this kind, specialists medical institutions X-ray and rhinoscopy are widely used. But a special place among similar diagnostic methods is occupied by endoscopy of the nasopharynx. 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:

• unexplained nosebleeds;
• migraine;
• chronic snoring;
• pulsating and squeezing headache;
• prolonged runny nose;
• curvature of the nasal septum;
• mucosal injury or facial bones;
• labored breathing;
• violations olfactory functions;
• significant hearing loss visible reasons;
• regular discharge from the nasal cavity;
• tinnitus;
• the presence of foreign objects in the respiratory tract;
• suspicion of a tumor process;
• growths on the tonsils.

Endoscopy is often included in preparatory stage rhinoplasty

If small child there is no corresponding level of speech development, most likely the specialist will prescribe endoscopy nasopharynx in order to exclude problems with the ENT organs. Long-term use medical preparations, designed to expand the nasal vessels, becomes the cause of their weakening, destruction. Similar case is also an indication for the procedure.

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

Carrying out the procedure

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

The procedure begins with local anesthesia with an anesthetic, which will take 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 to the back of the chair and try to relax.

Then the specialist gently inserts the disinfected narrowest part of the endoscope into the nose through the nostrils in turn, examining the condition of the nasopharynx and auditory tubes. On the this stage, as a rule, it takes no more than 5-8 minutes.

If during the examination significant deviations from the norm are revealed, then the specialist can carry out a parallel medical manipulation such as a biopsy. Features of endoscopy of the nasopharynx for a child are described in this article.

Contraindications

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

• allergy to painkillers Novocain 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;
• severe neurological abnormalities that cause uncontrolled body movements;
• underdeveloped vascular network of the nose.

How to properly prepare

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

What can be detected with an endoscope

Thanks to the improvement of the latest models of laryngoscopes, it became 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 auditory canals allows you to identify congenital or acquired anomalies of the structure, similar to a closed curvature of the nasal septum.

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

Price

The price of a diagnostic procedure for the pharynx and 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 want to conduct video endoscopy, which involves transferring the disk with the results to the patient's hands, then you will have to pay a little more - 2600-3500 rubles per session.

Among the numerous methods for diagnosing diseases of the nose and throat, endoscopy of the nasopharynx occupies a special place.

This method of examination allows you to recognize the disease at the very early stage its origin and prescribe timely treatment.

Endoscopy of the nasal cavity and nasopharynx is performed using an apparatus 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.

Endoscopy of the nasopharynx: what is it?

Examination with the help of this technology is possible both for regular examination and to clarify a previously made diagnosis. The diagnostic procedure can be carried out at different angles and under magnification, which guarantees the accuracy of the results.

This type of diagnostics belongs to low-traumatic. It is widely used in surgical operations in the region of the nasopharynx.

It does not require surgical incisions, lengthy training and recovery period.

Endoscopic diagnosis of the nasopharynx is a painless procedure lasting only a few minutes, causing minimal discomfort patients. These advantages allow us to recommend this manipulation to people of all ages, including children.

What diseases is it prescribed for? Indications for the procedure

This examination allows for early 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

Its useful to note

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 problems and
• regular headaches of unknown origin;
• secretion of mucus, pus and blood from the nasal passages;
• hearing problems and underdevelopment of speech in children;
• frequent occurrence of "noise" and congestion in the ears;
• feeling of pressure and flushes of heat in the face.

Endoscopy is performed when snoring during sleep and in order to establish or damage the nasal septum. The diagnostic procedure is performed during preparation for surgery and in the postoperative period.

Contraindications to the procedure

Absolute contraindications to endoscopic examination no. A certain obstacle to its implementation may be the presence of an allergy to anesthetics that are used to treat the nasal cavity before the diagnosis.
Source: website Other contraindications include:

• the presence of regular intensive
• weakened vessels;
• low blood clotting.

Hypersensitivity of the mucous membranes, which is more common in children, should also not be a contraindication to endoscopy. In this case, an ultrathin apparatus is used, the use of which eliminates the risk of trauma to the nasopharynx.

How to prepare for an endoscope examination?

Endoscopy of the nose does not include any prior preparation. It is well tolerated by most patients and, as a rule, does not cause fear and discomfort even in young children.


If the child is still afraid of an unknown procedure, 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. During the diagnosis, you do not need to make sudden movements or worry. The body should be as relaxed as possible, and breathing should be even and calm.

Endoscopic examination of the nasopharynx: how is it performed?

Endoscopic examination is carried out in several stages. Immediately before the manipulation, the nasal passages are cleaned and irrigated. This is necessary to reduce the swelling of the mucosa and increase visibility.


The gel is applied to the end of the tube. Under the influence of an anesthetic gel, numbness of the nasal passages occurs, a decrease in their sensitivity, due to which the doctor freely inserts the endoscope into the nose to determine the pathology.

During the examination, the patient sits in a chair, slightly tilting his head back. At the second stage, the doctor examines the vestibule of the nose for inflammation or purulent formations.

The nasal endoscope used during manipulation can be flexible or rigid. The test results are displayed on the screen.

During the manipulation, the doctor receives a visualization of the state of the anterior parts of the nasal cavity, nasal passages, septum, rear walls.


After the examination, the doctor removes the tube from the nasal cavity, prints out pictures of areas with pathological changes and makes a conclusion, the data of which are taken into account in further treatment.

How to do an endoscopy for a child?

Many parents are incredulous about the procedure, because they are not sure that their child will behave calmly. But in most cases anxiety state in children who do not fully understand the significance of the procedure.

Attention

The diameter of the tube that is used for children is no more than 3 mm. Also, shortened nozzles are used to diagnose diseases in babies. An experienced doctor will need no more than 2-3 minutes to conduct a full examination.

With the help of endoscopic nozzles, you can easily penetrate into parts of the nose or pharynx that are inaccessible to the eye. Additional illumination and magnification make it possible to study pathological changes in detail 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. With the help of an endoscope, it is easy for a doctor to assess the condition of the adenoids and the presence or absence of fluid behind the membrane.

Video endoscopy of the nose- the only one reliable method detection and observation of adenoid hypertrophy in their development. Such manipulation is possible at any age of the child. Parents can hold very young children in their arms during the examination.

What can be detected by 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 you to identify other, less common pathologies.

Small children very often, during the game, put various small objects in their nose. At the same time, the child develops swelling of the mucous membranes, discharge of mucus and even pus from the nasal passages, which are difficult to explain. Easily detectable by endoscopy foreign object in the nasal cavity.

Attention

If a patient is suspected of having malignant tumors, with help this method diagnostics, it is possible to accurately determine the color of mucous membranes, the presence of spots or damage, the thickness of tissue growth.

Pediatric nasopharyngeal endoscopy is also used to establish 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 about whether it hurts or not, to do endoscopy of the nasopharynx. They are afraid of possible Negative consequences procedures.

In some cases, there may be:

• allergic reactions to local anesthetics;
• discomfort during its implementation and minor pain in the nose for a few hours afterwards;
• nosebleeds;
• dizziness.

If the procedure is performed in a reputable clinic with an experienced specialist, such complications are very rare. The pain syndrome is eliminated using local anesthesia.


When the tube is inserted, the patient feels a slight pressure, which is not dangerous. For children, flexible instruments are used that do not scratch the mucous membranes and do not injure them.

If the patient has a predisposition to frequent bleeding or is taking coagulants, these facts should be reported to the doctor, as they can provoke nasal bleeding.

Where to do an endoscopy of the nasopharynx for a child?

Which doctor conducts this diagnosis? Endoscopy is usually performed by an otolaryngologist in a treatment room.


The survey is carried out in specialized clinics and medical centers equipped with modern equipment and licensed to provide this type of medical services.

Your doctor may order a blood test before an endoscopy. 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.

Indications and contraindications for endoscopy of the nose and nasopharynx

Indications

Contraindications

Clinical manifestations, which the patient complains about, and which are indications for endoscopy of the sinuses and nasopharynx are the following: labored breathing; frequent snoring; dysfunction of the sense of smell; persistent discharge from the nose and ears; hearing impairment; frequent bleeding from the nose; frequent headaches of unknown etiology; inflammatory diseases nose and nasopharynx; speech delays in children. Diagnostics is mandatory the following diseases: inflammation of the frontal sinus - frontal sinusitis; inflammatory processes of the ethmoid labyrinth; inflammation of the mucous membrane of the nasal strip - rhinitis; Inflammatory processes pathological overgrown palatine tonsil- adenoiditis; Inflammation of the mucous membrane of the throat - tonsillitis. Indications are also past 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 nosebleeds, he needs to warn the doctor about this. He will perform the procedure using the thinnest endoscope, which is used for endoscopy of the nasopharynx in children. The method is also used with caution if the patient has a too sensitive mucous membrane or has certain neurological disorders. If the patient has an allergic reaction to the agents used for local anesthesia, those to 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 preparation from the patient. As a rule, before it is carried out, the diagnostician talks about exactly how it will be carried out and answers all the questions of the patient. If the procedure will be carried out on a child, it is necessary for the parents to prepare him and tell him that in the process you need to behave calmly and not move. If you feel discomfort, you should immediately tell your doctor about it.

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

After the tool 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 the writing of the conclusion.

If there are indications, endoscopy of the pharynx may be curative. In the process of its implementation, neoplasms can be removed, but only if the procedure does not lead to heavy bleeding or mucosal injury. The use of an endoscope eliminates unattractive scars and 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 baby how it will be carried out and how to behave while the doctor performs all the necessary manipulations. It is necessary that the child understands that attempts to interfere with the doctor can lead to unpleasant consequences and prolong the time for the diagnosis.

What does nasopharyngeal endoscopy show?

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

• Any neoplasm of mucous membranes;
• polyps;
• Diseases of the maxillary sinuses;
• Pathological growth of adenoid tissue;
• Damage to the walls of the nasopharynx.

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

Benefits of nasopharyngeal endoscopy at Doctor Nearby Clinic

We carry out the procedure for both adults and young patients. Our specialists have modern endoscopes that allow us to make the procedure minimally uncomfortable. In the process, effective anesthetics are used, and our diagnosticians know how to find an approach even to the most capricious babies.