Introduction to Nasal Endoscopy
Nasal endoscopy is a vital tool for diagnosing and managing sinusitis. It involves using an endoscope to visualise the nasal passages and sinuses, providing detailed images that help ENT specialists identify various nasal conditions. Nasal endoscopy can be both diagnostic and therapeutic, but this article focuses on its role in diagnosing sinusitis.
Diagnostic Nasal Endoscopy (DNE) for Sinusitis
Diagnostic Nasal Endoscopy (DNE) is a minimally invasive procedure that allows doctors to see inside the nasal passages and sinuses. Using a 0-degree or 30-degree telescope, the endoscope provides a clear view, making identifying issues such as nasal polyps, pus, and other abnormalities easier.
Telescopes Used for Sinuses
The endoscopes used in nasal diagnostics are typically equipped with 0-degree or 30-degree angular telescopes. These telescopes vary in diameter, with the most common sizes being 2.7mm and 1.9mm. The 2.7mm telescope is preferred for comfort as it gives broader view, if the nasal passages are narrower then 1.9mm telescope is used.
0-Degree Telescope: Used to examine areas directly ahead of the endoscope.
30-Degree Telescope: This allows the doctor to see the lateral walls of the nasal cavity by rotating the endoscope.
Dr. K. Raja Meghanadh and his team at Maa ENT Hospital use these telescopes to ensure a thorough examination of the nasal passages and sinuses.
Identifying Nasal Polyps
Nasal polyps are grape-like structures that block nasal and sinus drainage paths. During the early stages of sinusitis (grade 1), these polyps are visible only through endoscopy. In more advanced stages (grade 4), they can be seen without special equipment. Nasal polyps often indicate chronic sinusitis and may require further diagnosis.
Detecting Discharge and Infections
Endoscopy can reveal mucoid discharge resembling thin gum strings and pus in the sinus openings. Yellow pus typically indicates a bacterial infection caused by Staphylococcus, while green pus suggests a long-standing bacterial infection by Pseudomonas aeruginosa.
This data helps prescribe appropriate antibiotics to the patient.
Preparation and Anesthesia for DNE
No specific preparation is needed for DNE. Patients are advised not to blow their nose before the procedure to allow accurate observation of any pus or blockages.
General anesthesia is not required; local anesthesia with xylocaine nasal drops may be used for patients sensitive to touch or requiring deeper examination.
Complications and Side Effects
There are no side effects from nasal endoscopy.
Side effects from local anesthesia are rare, affecting about 1 in 30,000 patients. Possible symptoms include sweating, nausea, or low blood pressure, which can be managed effectively in a hospital setting. Since xylocaine is applied topically, any adverse effects usually subside within 3 to 4 hours.
Cost of Nasal Endoscopy for Diagnosing Sinusitis
In India, the cost of Diagnostic Nasal Endoscopy for sinusitis can range from 1000 INR to 2000 INR (12 to 24 USD).
Conclusion
Nasal endoscopy is an essential diagnostic tool for sinusitis. It provides detailed images that help identify various nasal conditions. It offers a comprehensive view of the sinuses, aiding in accurate diagnosis and effective treatment planning.
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