Nasal Endoscopy

What is nasal endoscopy?

Nasal endoscopy is a procedure to look at the nasal and sinus passages. It’s done with an endoscope. This is a thin, flexible, or rigid tube with a tiny camera and a light. An ear, nose, and throat doctor (ENT or otolaryngologist) will often do this procedure in their office. Both flexible and rigid nasal endoscopy are safe and well-tolerated when done by an experienced doctor.

The sinuses are a group of spaces formed by the bones of your face. They connect with your nasal cavity. This is the air-filled space behind your nose.

During the procedure, the healthcare provider puts the endoscope into your nose. They guide it through your nasal and sinus passages. Images of the area can be seen through the endoscope. This can help diagnose and treat health conditions. In some cases, small tools may be used to take tiny samples of tissue (biopsy) or do other tasks such as tissue debridement or removal of a foreign body.

Why might I need a nasal endoscopy?

You might need a nasal endoscopy if your healthcare provider needs more information about problems such as:

• Nasal congestion
• Nasal blockage
• Nasal and sinus infection (rhinosinusitis)
• Nasal polyps
• Nasal tumors
• Nosebleeds
• Decreased or loss of ability to smell
• Cerebrospinal fluid (CSF) leak

The endoscopy can show certain details, such as the site of bleeding and swelling of nasal tissue. It can also be used to look at a growth that might be a benign nasal polyp or cancer.

In some cases, a nasal endoscopy can be used as a treatment. For example, it may be done on a child to remove a foreign object from their nose.

Your healthcare provider might also advise endoscopy to see how treatment for a nose or sinus problem is working. For example, it can show if nasal polyps have shrunk.

Rhinosinusitis (inflammation of the nasal and sinus linings) is one of the most common reasons for nasal endoscopy. You may have symptoms such as nasal blockage, yellow or greenish fluid from your nose, and facial pain. Your healthcare provider can use the endoscope to look for swelling and polyps. They may collect pus from the infected area. This can help show what is causing an infection and how best to treat it.

A healthcare provider may use a nasal endoscope to do minimally invasive surgery. This is done in a hospital or surgery center. It can treat conditions such as sinus infection, nasal polyps, and nasal tumors. The surgery is done with very small tools and does not need an external cut (incision).

What are the risks of a nasal endoscopy?

Nasal endoscopy is generally safe. But in rare cases, there may be complications such as:

• Nosebleed
• Fainting
• Harmful reaction to the decongestant medicine or anesthetic

You may be at greater risk for bleeding if you have a bleeding disorder or if you take a blood thinner. Your own risks may vary according to your age and your other health conditions. Ask your healthcare provider about the risks that most apply to you. Rarely, an infection may occur after a nasal endoscopy. Contact your healthcare provider if you notice any signs of infection such as fever, chills, or foul-smelling nasal discharge.

How do I get ready for a nasal endoscopy?

Ask your healthcare provider if you should stop taking any medicines before the procedure. These may include blood thinners. You should be able to eat and drink normally before the procedure. Your healthcare provider may give you more instructions about what to do before the test.

Just before the procedure, a topical decongestant may be sprayed into your nose. This helps reduce swelling and lets the nasal endoscope pass easily through your nasal cavity and sinuses. Your nose may also be sprayed with an anesthetic, which will briefly numb your nose. In certain cases, you may also need a shot (injection) of anesthetic.

What happens during a nasal endoscopy?

Ask your healthcare provider about what to expect during your nasal endoscopy. The following are some things you might experience in a typical procedure:

• For the procedure, you will probably sit upright in an exam chair.
• After numbing the area, your healthcare provider will place the endoscope into one side of your nose.
• You may find this a little uncomfortable. If so, let your healthcare provider know. You may need more numbing medicine or a smaller nasal endoscope.
• In one nostril, your provider will push the endoscope forward to view a part of the nasal cavity and sinuses.
• They may repeat this step 2 more times on the same side of your nose. (Each pass lets your healthcare provider see a slightly different part of your nasal cavity and sinuses.)
• Your provider may then repeat the procedure on the opposite side of your nose. Again, they may need a few passes of the scope to get the needed information.
• If needed, your provider may remove a tissue sample as part of the endoscopy. They may send this tissue to a lab to be checked.

What happens after a nasal endoscopy?

Talk with your healthcare provider about what to expect after your nasal endoscopy. Ask if they have specific instructions. If you had your procedure in the office, you should be able to go home right after the procedure. You should be able to go about your activities as normal. Let your healthcare provider know if you have a nosebleed that doesn’t go away.

The nasal endoscopy often provides the information needed to create a treatment plan. You might discuss this with your healthcare provider right after your endoscopy. In other cases, they might want to order more tests, such as a CT scan. If you had a tissue sample taken during your procedure, these results may take a few days to come back.

Follow all of your healthcare provider’s instructions about medicines and follow-up. In many cases, your healthcare provider will want to schedule another nasal endoscopy in the future to see how your treatment has progressed.

Next steps

Before you agree to the test or the procedure, make sure you know:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• Who will do the test or procedure and what that person’s qualifications are
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how you will get the results
• Who to call after the test or procedure if you have questions or problems
• How much you will have to pay for the test or procedure