Nasal Endoscopy & Laryngoscopy
What is nasal endoscopy? An endoscope is a small and thin (less than the size of a pencil) rigid or flexible viewing tube with a light on one end and an eyepiece or camera attached to a video monitor on the other end. It is used to look through small holes into larger spaces. Endoscopes are used by many types of doctors to evaluate many spaces including the lungs, stomach, nose and sinuses.
ENT doctors use endoscopes to look at the vocal chords and other throat tissue also. Nasal endoscopy is probably done in every ENT office more than 10 times per day. Before nasal endoscopy the staff will spray your nose with a topical decongestant, to reduce the swelling and widen the path for the endoscope, and a topical anesthetic, which numbs the nose and helps decreases the chance of sneezing. The procedure is not usually painful, but some patients experience discomfort from the pressure of the endoscope. More numbing spray or a pediatric scope may help with such discomfort.
Nasal endoscopy allows a detailed examination of the nasal and sinus cavities. During the endoscopy, the physician or other certified provider will look for areas of swelling in the mucosal membranes, for the presence of purulent secretions draining from the sinus openings, for enlargement of the turbinates, and for the presence of polyps. If pus is seen, it may be sampled to determine what organism is causing the infection. Nasal endoscopy is the most important diagnostic exam that an ENT will need to help with determining what may be causing sinus problems.
How we look into your nose / sinuses? When you come to CSI with a nose or sinus related problem, the doctors may want to perform a nasal endoscopy. This is a surgical procedure using sterile small cameras to look through the nostrils. This may allow your doctor to:
- obtain drainage for culture
- evaluate previous surgery, scar, openings, masses, polyps, causes of blockage
- evaluate healing or complications of surgery
- obtain specimens / biopsy for pathology evaluation
- remove old blood, foreign material, packing, scabs/scar/blockage
- educate you and others: We can use video glasses / TV screens to show inside also
The nurse will have you sign a permission form first then offer to spray your nose to make the procedure easier. The spray is a combination of Afrin (to shrink tissue) and Lidocaine (to numb). This spray does taste bad and can cause teeth/throat numbness that wears off in about 20-30 minutes. Some patients have a sensation that they can't swallow also- do not panic - this will pass.
Two words you need to remember during this procedure:
"Ouch": allows us to know where it is tender
"Sneeze": allows us to get outta there fast.
A few patients experience significant discomfort/pressure during the procedure.
The video glasses/ TV Screens allow you to see and can decrease the anxiety related to this. Less than 5% of patients faint/get queasy also - called a vasovagal reflex - we will put these patients chairs back and allow them to relax for a few minutes and this goes away.
For more information, visit
An Introduction to Nasal Endoscopy
More information on the video glasses and TV Screen
Office Based Flexible Laryngoscopy A transnasal flexible laryngoscope can be used for office-based diagnostics. This office exam is extremely well tolerated and often performed multiple times per day to patients of all ages. This can even be performed on newborns if medically required. Prior to passing the scope, the patient's nose is decongested and anesthetized with topical sprays that do NOT sting or burn. The patient then sits in an upright position and the scope is passed along the floor of the nose into the back of the throat to a level just above the vocal cords. At this point the patient is asked to breath deeply and phonate, allowing the physician to directly observe the structure and dynamic motion of the true and false vocal cords. There are no lasting side effects to this procedure and the anesthetic spray wears off over the ensuing 1-2 hours.
Common reasons for performing this procedure during your visit include hoarseness, suspected vocal fold lesions, chronic shortness of breath, difficulty or inability to swallow, longstanding history of smoking, the need for postoperative visualization or tumor surveillance, and inability to otherwise visualize the vocal cords during the exam.
Rigid Nasal Endoscopy Rigid nasal endoscopy can be used for office-based diagnostics. This exam is extremely well tolerated and is performed on adults and children who are able to cooperate with the exam. Prior to passing the scope, the patient's nose is decongested and anesthetized with topical sprays that do NOT sting or burn. The patient then sits in an upright position and the scope is gently passed through the nasal cavity to the back of the nose. This exam allows a complete and detailed visualization of all nasal mucosa, nasal turbinates, openings into the sinuses, and nasopharynx. There are no lasting side effects to this procedure and the anesthetic spray wears off over the ensuing 1-2 hours.
Common reasons for performing this procedure during your visit include nasal airway obstruction, suspected acute or chronic sinusitis, nasal/facial pain, altered sense of smell, and nosebleeds.
NOTE: This information is not intended to substitute for a consultation with your physician. It is offered to educate the patient and his or her family on the basis of otolaryngology conditions in order to get the most out of their office visits and consultations. Please see our disclaimer for additional information