ENT doctor endoscopy. Endoscopy of ENT organs for children. Where can I get research

Endoscopic equipment allows the doctor to conduct a quick and high-quality examination, without the use of additional procedures or tests, as well as perform the necessary manipulations for the treatment or operation of the patient. Examination and treatment with an endoscope is absolutely painless for the patient. All manipulations are carried out without anesthesia (its use is possible at the request of the patient) and does not cause inconvenience or pain. In addition, all manipulations are absolutely bloodless and non-traumatic.

The advantages of this method of examination are numerous, both for patients and for otolaryngologists:

Endoscopic examination allows you to examine at high magnification all the organs of the nasopharynx and ear, establish a lesion or inflammation, assess the condition of the tissues, and identify the cause of the disease.
It is also important that during endoscopy, a specialist doctor can take biomaterial for analysis, for example, mucous secretions, samples of affected tissues, etc. During endoscopy, the otolaryngologist performs not just an examination, but a complete examination of the patient, after which it is possible to make a final diagnosis and immediately begin treatment.
Often, in addition to endoscopic examination, no additional procedures are required to clarify the diagnosis or its details. Endoscopic examination is the most productive method of diagnosis, as there are no more informative methods of visual examination at this time.

For the patient, endoscopic examination also has a number of advantages. These include:

Painless, bloodless and safe procedure. Endoscopic examination does not require punctures or violation of the integrity of the mucosa, and also does not have a negative impact, such as x-rays.
Reducing the time of diagnosis, which is important for acute pain or intense manifestations of the symptoms of the disease. The brevity of the examination guarantees a quick start of treatment, and also eliminates the need to take several different tests or undergo a long examination with various methods.
Availability of the method in financial terms - endoscopic examination of ENT organs in the Otradnoye Polyclinic is carried out at very affordable prices. The versatility of the device allows you to reduce the cost of diagnosing the disease by conducting only one examination.

Indications for endoscopic examination

The need for a diagnosis can only be judged by an otolaryngologist, who also selects relevant diagnostic methods. However, given the versatility and ease of use of the endoscope, the diagnosis of diseases of the upper respiratory tract is increasingly carried out with its participation.

dysfunction of nasal breathing;
sensation of a foreign body in the airways, nasopharynx or ear;
severe pain in the throat or ear;
discharge of a yellowish or greenish color in the nasopharynx or ear;
temporary deafness, hearing loss;
prolonged runny nose and chronic inflammatory diseases of the ENT organs;
recurrent nosebleeds; dryness in the nasal mucosa, etc.

Endoscopic examination will help to identify such diseases:

curvature of the nasal septum;
sinusitis: acute, polyposis, chronic;
polyps;
adenoids;
laryngitis;
rhinitis: allergic, atrophic, hypertrophic, vasomotor, chronic;
foreign body of the larynx;
foreign body in the nose.

How is an endoscopic examination performed?

The procedure does not require prior preparation of the patient.

After the initial examination, an endoscope is inserted into the nasopharynx or ear of the patient, with the help of which a hardware-visual examination is performed. If necessary, the otolaryngologist takes samples of sputum, mucus or tissues for further analysis. After the procedure is completed, a conclusion is issued and treatment is prescribed.

You can make an appointment with a doctor and conduct an endoscopic examination at the Otradnoye Polyclinic by calling the phone number listed on the website.

Endoscopy is a highly informative, painless, easy-to-use and safe diagnostic technique that allows examination of the upper respiratory tract. Applies to patients with no age limit.

One of its main advantages is the absence of exposure to electromagnetic waves.

Endoscopy allows:

Control the process of treatment;
Track dynamics;
Monitor the condition of the adenoids and the mucous membrane of the nasal cavity;
If necessary, make adjustments to the treatment.

Endoscopic diagnostics is:

Detection of diseases in the early stages;
Wide diagnostic possibilities;
Accurate determination of the stage of pathology;
Identification of structural features of the body;
Reliability of the diagnosis;
Accurate assessment of the effectiveness of treatment.

Indications

The need for an examination of the ENT organs is determined by the doctor. Indications are signs of ENT diseases:

Respiratory failure;
Prolonged runny nose;
soreness in the ear or throat;
Signs of a foreign body;
Allocations;
hearing loss;
Lack of sensitivity;
bleeding;
Dryness of the mucosa.

Advantages of the method

Endoscopic examination allows you to see the state of the organs of the ear, larynx, sinuses and nasopharynx with a large increase, make a diagnosis, and immediately begin treatment.
There is no harmful effect, punctures and mucosal disorders.
The brevity of the examination, the absence of the need to take a lot of tests and conduct other types of diagnostics.
Affordable price.

Endoscopic examination reveals:

Deviated septum of the nose;
sinusitis;
polyps;
Adenoids;
Laryngitis;
Rhinitis; foreign bodies in the larynx and nose;
sinusitis;
Pharyngitis.

Are there any contraindications

Updated on 07.08.2019 12:25

What is endoscopy

In some cases, an examination using a nasal mirror is not enough to examine all the anatomical formations in the nasal cavity and nasopharynx. Although each of them carries a certain functional load.

Endoscopy helps the doctor get more information about the condition of the nasal cavity and paranasal sinuses. The procedure is performed with a thin endoscope, the diameter of which is less than 3 mm. This helps to see hard-to-reach places invisible during normal inspection under magnification. During the study, the condition of the mucous membrane of the turbinates, septum, sinus fistulas is assessed.

How is the procedure carried out

In the study, the doctor uses a rigid (in the form of a rigid tube) or flexible endoscope (in the form of a tube that can change direction when controlled), inside which is an optical system with a light source.

At the beginning of the examination, an endoscope with direct optics is used, then with lateral optics (30, 45, 70 degrees) to increase the viewing angle.

In the photo, the ENT doctor of the clinic, Ph.D. Ryabova Svetlana Valerievna conducts an initial examination of an adult patient using video endoscopic equipment.

Preparation for the examination

Endoscopy does not require special preparation.

Before the start of the examination by the doctor, it is possible to irrigate the nasal cavity with vasoconstrictors, after which the swelling of the mucous membrane decreases. Due to this, the view is increased, and the endoscope practically does not touch the structures of the nasal cavity.

Use of anesthesia

Endoscopy is possible without anesthesia (with a thin endoscope and with wide nasal passages) or with local irrigation of the mucous membrane with any anesthetic.

How is an endoscopy performed?

Inspection begins with the study of the lower nasal passage, the endoscope is carried out to the nasopharynx, the nasopharynx, the mouth of the auditory tube, and the choana are examined. Then the sphenoidal pocket, upper and middle nasal passages are examined (these are the areas where the fistulas of the paranasal sinuses open).

What can an endoscope see?

pus or mucus with the development of an inflammatory process in the paranasal sinuses;
polyps with the development of a polyposis process in the sinuses;
neoplasms in the nasal cavity, nasopharynx;
mucosal hypertrophy.

Endoscopy in children

Endoscopy helps to more accurately assess the condition of adenoids in children and the degree of their hypertrophy. X-ray does not provide complete information about the onset and stage of inflammation of the adenoids, the presence of swelling of the mucous membrane of the adenoids, the type of pathological discharge on their surface.

In the photo, the ENT doctor of the clinic conducts video endoscopy of the girl's nose.

Nasal endoscopy at the Ear, Nose and Throat Clinic

A modern approach to examining a patient should include an endoscopic examination of the nasal cavity and nasopharynx to make an accurate diagnosis, choose the tactics of management and treatment of the patient.

In our clinic, endoscopic examination is the standard of diagnosis and treatment and is included in the cost of the initial appointment. Experienced ENT doctors of the clinic painlessly and quickly perform an examination using an endoscope.

A routine examination of the nasal cavity does not make it possible to evaluate all its anatomical structures. Most of them are not accessible to visual inspection due to their location. Therefore, endoscopy of ENT organs is used for their study.

In Russia, this method has been used for more than two decades. Thanks to the successful development of technology, endoscopic equipment is gaining more and more opportunities. For example, the image obtained with the device is transmitted to the monitor and allows you to record during the study.

Endoscopic rhinoscopy

Indications for endoscopy

A child, as well as an adult, is assigned a similar study with the following indications:

Violation of normal nasal breathing.
Nasal congestion not relieved by conventional means.
Pain and discomfort in the paranasal sinuses.
Snore.
Decreased hearing acuity.
Swallowing disorders.

There are no absolute contraindications for examination with an endoscope. If the patient has disorders of the blood coagulation system, as well as allergies to drugs, the doctor must be warned about this in advance.

Study preparation

Special preparation for such an examination is not required. If the study is carried out as a diagnosis of a child’s diseases, then his parents should explain to the baby that there is no need to be afraid of the doctor and this examination. They should tell you that the examination takes a few minutes and is painless.

The advantage of endoscopy is the absence of discomfort during the procedure, which allows it to be successfully used in children.

ENT endoscope

For anesthesia, a local anesthetic containing lidocaine is used. It is applied to the tip of the endoscope tube and sprayed into the laryngopharynx. In the latter case, an anesthetic in the form of a spray is used. This provides numbness to the tissues in the area under study, allowing the insertion of the endoscope without discomfort. Of the medicines, vasoconstrictor drugs are used in the form of drops or spray. Their action reduces swelling of the mucous membrane and improves visibility.

Methodology for children and adults

Children are allowed to perform endoscopy of ENT organs from the age of three. The general procedure for performing manipulations in patients of different ages does not differ. Differences may be associated with the indications for which endoscopic examination is prescribed, but the technique itself is the same.

The procedure is carried out in the following sequence:

The patient sits in a chair and throws his head back. This is done to facilitate the examination of the ENT organs, which is achieved by straightening the line of the pharynx when tilting the head back.
Next, the specialist inserts the instrument into the ear, nose or throat, depending on what indication the procedure had.
If the patient is a child or the owner of a sensitive mucosa, then anesthesia is performed with the above drugs.
The doctor receives an image of the organ under study with further advancement of the endoscope.

Videoendoscopy of the nose and nasopharynx

At the end of the procedure, the specialist takes out the device and prints or saves pictures of the areas in which problems are identified. On their basis, a conclusion and recommendations for further treatment are given.

Endoscope Capabilities

Due to its small size and flexible tube, the endoscope has much wider access than a normal examination can provide. The device can see and help the specialist evaluate:

Degree and extent of inflammation.
The presence of pus or mucus.
The degree of development of adenoids, polyps or other neoplasms.
Mucosal hypertrophy.

Do I need to do an endoscopy? Due to the wide possibilities of the method, its appointment is expedient, and in some cases even mandatory, for example, in case of hearing pathologies and adenoids.

Videoendoscopy

This is a modern research method that has advantages over conventional endoscopy:

Improved inspection quality.
Ability to record research in high quality.

In fact, there are no other differences from endoscopy. But precisely because of the ability to record the entire course of the study in video format, you can play it at any time and compare later with other results. Saving the results helps in building the most successful line of treatment and monitoring the activities already carried out.

The production of study records helps in quality control of the therapy and further diagnostics.

Improving the quality of the video camera can significantly increase the level of diagnostics. As a result, the likelihood of various pathological processes in the early stages increases.

Where can you do research?

Endoscopy is carried out in specialized ENT departments of hospitals and in a regular clinic. Also, private centers offer their services. You can navigate in this abundance of choice by several parameters:

Availability.
The level of training of specialists.

Almost every procedure for examining patients for pathologies of the ENT organs necessarily includes, in addition to examination and anamnesis, also instrumental diagnostic methods aimed at visualizing the internal state of the organs. Various types of micro- and endoscopies act as such instruments.

Microscopy of ENT organs

Microscopy is the examination of mucous membranes. ENT organs under a microscope.

Microscopy is the only accurate tool for making an accurate diagnosis. It is carried out using specialized ENT microscopes (link to our models), which allow diagnosing both atypical and sluggish inflammatory processes of the middle ear, tympanic membrane and the walls of the auditory canal itself. The most important difference between these microscopes and ordinary ones is the possibility of carrying out medical procedures and microsurgery simultaneously with the examination.

Figure 1. Specialized otolaryngological microscope Haag-Streit Surgical ALLEGRA 50

A similar procedure is performed without any anesthesia or surgical intervention. During the procedure, the doctor sits in front of the patient and sets the microscope with the light source in the required position so that the eardrum can be effectively examined.

With this diagnostic, you can determine:

injuries caused by a sharp drop in pressure (rupture of the membrane);
perforation of the tympanic membrane;
inflammation of the tympanic membrane and middle ear.

Endoscopy of ENT organs

Endoscopy of ENT organs- this is an examination of the mucous membranes of the upper respiratory tract with the help of endoscopes. This procedure is carried out both for the respiratory tract (nasopharynx, larynx, trachea), and for the auditory organs.

According to the method of image transmission, all endoscopes are divided into:

fiberscopes- a cheaper type of endoscope, in which the image is transmitted through the optical system to the viewing eye on the endoscope. As a result, the image is not processed and only the doctor can see it.

Video endoscopes- a device with a camera installed at the end of the endoscope, the image from which is displayed on a specialized medical monitor through an image processing system.

Depending on the area (ear, throat, nose), apply:

pharyngoscopy - examination of the oral cavity and pharynx ;
laryngoscopy - examination of the larynx;
stroboscopy - examination of the vocal cords;
rhinoscopy - examination of the nasopharynx;
otoscopy - examination of the middle ear and auditory canal;
nasopharyngoscopy - an examination conducted to exclude malformations of the tonsils and adenoids;
sleep endoscopy - examination of the upper respiratory tract with a flexible endoscope during medication sleep. This is an innovative solution in the diagnosis of snoring and apnea.

An interesting feature: not all such devices can be attributed to endoscopes. For example, the Heine Mini 3000 viewing otoscope is not one of them, because it cannot be connected to a cold light source or an image capture system.

The use of endoscopy in otolaryngology opens up wide opportunities for access to previously closed sections of the nasal cavity, maxillary and frontal sinuses, as well as the larynx, where the doctor cannot physically look. This technique makes the detection of mucosal polyps and deformities of the nasal septum easier, allowing an accurate diagnosis of the patient's condition. In addition, the endoscopic technique used for the ear section makes it possible to describe the inflammatory processes of the middle ear, to assess the state of the tympanic membrane.

For example, the pharynx is quite successfully examined using the fibrolaringoscopic technique. It allows you to visually evaluate all the features of its structure, as well as take pictures / videos. Another method of examining the larynx is known, it is called microlaryngoscopy. The technique involves the analysis of the vocal cords and the larynx as a whole under optical magnification using a rigid video endoscope (stroboscope), often inserted into the trachea using an intubation laryngoscope (through the laryngoscope, the endotracheal tube passes through the oral cavity and larynx, entering the trachea between the vocal cords).

Today, stroboscopes are the only imaging tool that allows complex examinations of the trachea and voice-forming apparatus. The use of such a technique allows you to accurately determine the source of the problem and purposefully influence local areas of the larynx. It is very important that no additional incisions on the neck are required to insert the stroboscope into the larynx, everything happens through the natural respiratory tract.

As for the nasopharynx, a method called fibrorhinopharyngoscopy is actively used today. This technique only allows visualization of the nasopharynx with simultaneous biopsy, which is very convenient when verifying suspicions of a tumor.

Auxiliary equipment

For endoscopic diagnostics and therapy, in addition to the ENT combine with endoscopy support, as well as related ENT equipment, the following devices are needed:

For video endoscopy

specialized video endoscope (Atmos also uses video capture of images from fiberscopes, i.e. the endoscope can be used simultaneously as both a video and a fiberscope);
cold light source with light guide;
medical monitor.

For fibroscopy

Specialized fiberscope;
Cold light source with light guide.

With the help of endoscopic diagnostics, it is possible to identify and determine:

the level and degree of obstruction of the respiratory tract;
pathology of narrowing of the oropharynx;
the physical condition of the epiglottis;
shape, size of the root of the tongue, distant palate and uvula.

Indications for endoscopic examination:

trouble breathing through the nose;
copious discharge from the nose;
smell problems;
snore;
stops breathing in a horizontal position (during sleep);
problems with the function of the auditory tube;
recurrent nasal bleeding;
tumors of the nasal cavity;
chronic tonsillitis;
acute and chronic laryngotracheitis;
dysphonia (violation of voice functions).

Conclusion

The use of the latest technologies of microscopy and endoscopy in the treatment of ENT diseases allows several times to simplify not only the definition of the diseases themselves, but also provide a reasonable explanation to the patient regarding the pathology, showing this on a video image.