Rhinoscopy is the examination of the nose. It is performed by two procedures:
- Anterior rhinoscopy
- Posterior rhinoscopy
What is anterior rhinoscopy?
Anterior rhinoscopy is performed as a part of physical examination in the clinic. It is performed using an instrument called a nasal speculum. The doctor wears a headlight to free up the hands and shines the light into the nose. The speculum is placed in the nostril that helps widen the nostril. The same is repeated for the other nostril. Anterior rhinoscopy takes less than a minute to perform. It helps evaluate the condition of the nasal mucosa, discharge, position of the nasal septum, foreign bodies, and presence of any abnormal growths and nasal masses. Anterior rhinoscopy can be performed with or without using a topical nasal decongestant.
What is posterior rhinoscopy?
Posterior rhinoscopy is done to examine the post-nasal structures. Structures seen in posterior rhinoscopy include the posterior end of the nasal septum, posterior end of the turbinate (nasal bone), fossa of rossenmuller (a common site for malignancy), eustachian tube opening, and the upper surface of the soft palate. It can be performed using a post-nasal mirror or using an endoscope.
Posterior rhinoscopy using a mirror: The mirror is called St. Claire Thompson post-nasal mirror. Posterior rhinoscopy is a simple outpatient procedure that takes less than a minute and part of the physical assessment. The mirror is warmed and introduced into the oral cavity, whereas the tongue is depressed with a tongue depressor. Reflection of the post-nasal space falls on the mirror, which the doctor studies.
Posterior rhinoscopy using an endoscope: Diagnostic nasal endoscopy is a diagnostic medical procedure that involves the examination of the internal structures of the nose and/or the throat. It detects and diagnoses abnormalities in the nasopharyngeal area. It is done using a thin, rigid or flexible scope with a camera attached (nasopharyngoscope).
A flexible nasopharyngoscope can be used to evaluate the nose and throat at the same time, whereas a rigid endoscope can only be used to evaluate the nose. In both the scopes, there is a camera and light source. The camera is connected to a monitor to view the magnified video and images captured by the camera. The videos can be recorded for future reference. This procedure is performed by an ear, nose, and throat (ENT) surgeon (otorhinolaryngologist).
Some nasopharyngoscopes are also equipped with suction apparatus and forceps (grasping instruments) that can be used to clear the nose, sinus, or throat and perform a biopsy (collection of tissue samples) if needed.
This is typically an outpatient procedure and usually only takes a few minutes. Local anesthesia is used in the nose and throat to minimize discomfort. It can also be performed in children. Children may require a mild sedative to undergo the procedure.
Nasopharyngoscopy helps ENT surgeons help evaluate the nose, sinuses, and throat. It can help to evaluate the following conditions:
- Long-standing nasal congestion
- Chronic sinusitis
- Nasal polyps or abnormal growth in the nose
- Nasal tumors
- Nasal obstruction
- Foreign body in the nose or throat
- Epistaxis (bleeding through the nose)
- Dysphonia (problems with speech)
- Obstructive sleep apnea
- Dysphasia (difficulty swallowing)
- Progress after nasopharynx surgery or medical treatment
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