What can nasopharyngeal endoscopy reveal?

When you feel discomfort in your nose, you should go to the hospital for some examinations, because these examinations can not only help us check the current state of the nasal cavity, but also check the patient's current physical reaction. The nasopharyngeal endoscopy examination is mainly to check whether there is bleeding, roughness, congestion and ulcers in the nasal cavity. These abnormal symptoms are bad reactions and the causes need to be found in time.

There is no congestion, roughness, bleeding, infiltration, ulceration, or neoplasm on the mucous membranes.

Clinical significance

Abnormal results: abnormal mucosal color, congestion, roughness, scarring, swelling, etc. People who need to be examined: patients with nasopharyngeal lesions.

Precautions

Inappropriate groups: None. Taboos before inspection: Be careful to move gently and avoid rough operation. Requirements during the examination: ask the patient to open his mouth moderately, press the back of the tongue with the tongue depressor held in the left hand, hold the mirror held in the right hand and insert it through the mouth into the soft palate, with the mirror facing the nasopharynx, to observe the posterior nares. For patients who are nervous, they should be told to breathe quietly during the examination, or to practice breathing through the nose with an open mouth, so that the soft palate can droop and the nasopharyngeal isthmus can be widened to facilitate the examination. During nasopharyngeal endoscopy, avoid touching the posterior pharyngeal wall and move gently to avoid gag reflex.

For those with sensitive pharyngeal reflex, cocaine or tetracaine liquid spray can be used to anesthetize the pharynx and then checked after a few minutes. The soft palate can also be pulled forward with a soft palate retractor or rubber catheter to expand the nasopharyngeal cavity for easier observation.

Inspection process

During the examination, the subject should sit upright with head straight, open mouth naturally but not stick out tongue, and breathe quietly through the nose. Slightly warm the nasopharyngeal endoscope over an alcohol lamp to avoid fogging of the mirror surface, and first test it by placing the back of the mirror on the back of the examiner's hand to make sure it is warm but not hot. Then shine the reflected light of the frontal mirror on the posterior pharyngeal wall. Hold the tongue depressor in the left hand to press down the front 2/3 of the tongue. With the right hand, hold the nasopharyngeal endoscope from the left corner of the mouth (mirror surface facing up) to between the soft palate and the posterior pharyngeal wall in a pen-holding posture, avoiding touching the pharyngeal wall and tongue root to prevent nausea and affecting the examination. After insertion, tilt the mirror to 45 degrees. At this time, a part of the posterior nasal aperture will be reflected in the mirror. First find the posterior edge of the nasal septum, and then use it as a basis to check other parts separately. Because the mirror is too small, it cannot reflect the entire situation of the nasopharynx and posterior nasal aperture at once, and the mirror needs to be rotated appropriately to obtain the entire image.

What you see in the mirror is the opposite of the actual position. When the mirror is facing upward and forward, you can see the back of the soft palate, the posterior edge of the nasal septum, the posterior nasal aperture, the nasal passages and the posterior segment of the nasal concha; when the mirror is moved to the left and right, you can see the pharyngeal opening of the Eustachian tube and its surrounding structures; when the mirror is moved horizontally, you can observe the top of the nasopharynx and the adenoids. During the examination, attention should be paid to whether the mucosa has congestion, roughness, bleeding, infiltration, ulcers, neoplasms, etc.