Endoscopy of the nose for a child: how is the procedure for endoscopic examination of the nasopharynx. Description of the nasopharyngeal endoscopy procedure - preparation, conduct and diagnostic result Indications and contraindications

An endoscopic examination is a diagnostic procedure carried out in a hospital, on an outpatient basis. The study involves an analysis of the state of the mucosa, an assessment of the degree of curvature of the septum, the presence or absence of formations in the sinus cavity. The procedure involves the sampling of biological material for analysis and is done only if indicated. We also recommend that you familiarize yourself with. But why dryness in the throat and nasopharynx can occur and what can be done with such a problem is detailed

Description of the procedure

An otolaryngologist prescribes an endoscopic examination for a child, he recommends going through the procedure, if there are difficulties in making a diagnosis.

The study takes place in compliance with several rules, in order for it to take place it is necessary:

1. Explain to the child why they are doing the examination.
2. Explain the mechanism of action and behavior.

The child must understand how to behave and that attempts to place a doctor will lead to the fact that the duration of the examination will increase, at the time of its conduct, undesirable consequences will occur.

Indications

Endoscopy is performed when indicated. These include:

• frequent pain in the frontal or temporal lobe of the skull;
• bleeding from the sinuses;
• allocation of purulent secret from the sinuses;
• violation of the breathing process (on one or both sides);
• inability to breathe through the nose, the appearance of snoring at night (described by link);
• decrease in the severity of smell or its complete absence;
• violation of the perception of taste sensations;
• frequent rhinitis of unknown cause (link indicated).

The procedure is also carried out if the doctor for some reason cannot (difficulty) diagnose the patient. If there are indications, and there are no contraindications for an endoscopic examination, the ENT may recommend a procedure in order to make an accurate diagnosis.

An indication can also be considered an operation of an otolaryngological nature, the procedure can be carried out before performing surgical procedures, as well as after. This allows you to track the effectiveness of treatment, as well as to identify the presence or absence of indications for surgical manipulations.

On the video - detailed information about that. Why is this procedure done:

How is the procedure carried out?

Endoscopy is done following certain rules. It all starts with a visit to an ENT practitioner.

If there are indications, he recommends the procedure, finds out from the parents or the child himself:

1. Are there any complaints that indirectly or directly may indicate the presence of indications for the examination.
2. The presence of allergic reactions to lidocaine or novocaine.

It is worth noting that the procedure can cause certain sensations, including pain, provided that the child has narrowed nasal passages. This is considered an anatomical feature of the structure of the nasopharynx. In this case, the procedure is called into question.

How is the examination

• the endoscope is treated with an anesthetic and antiseptic solution;
• then gradually introduce it into the nasal sinus, examining it with a camera;
• the doctor examines the result personally and diagnoses the little patient.

On average, the study lasts from 2 to 5 minutes, if it is done to an infant, then the parents fix the position of the baby.

It is important that the baby does not move, does not create unnecessary interference. Otherwise, the child risks injury and damage, and the procedure may be disrupted.

Preparation for the event

It involves direct contact with the child. You can tell him the essence of the procedure, the scheme of its implementation and the algorithm of the doctor's action.

If a small patient assists the doctor, then the study:

1. It won't take long.
2. It will pass without consequences and complications.
3. It will allow you to obtain data on the state of the nasal mucosa, the presence of polyps and formations.

If the baby is afraid of pain, then it is worth explaining to him that the procedure may be accompanied by unpleasant sensations. But if you are worried about severe pain, then you should notify the doctor about it.

Examination does not require specific preparation, you should not refuse food or drink to the child. Since a local anesthetic is used, it is well tolerated, rarely leading to unwanted side effects. The drug acts only on the mucous membrane, it does not penetrate into the general blood flow.

Price

The cost of the procedure is considered acceptable, it is carried out in clinics that are equipped with specialized equipment. But this has little effect on the cost of the study, the price of the procedure does not exceed 2 thousand rubles.

Endoscopy of the nasopharynx for children is a highly effective, low-traumatic and painless method for diagnosing ENT diseases. Endoscopy of the nasopharynx is also called rhinoscopy. Children often suffer from respiratory diseases, and a focus of chronic infection develops in their nasopharynx, which causes various complications. Therefore, this diagnostic method becomes especially relevant.

Endoscopic examination of the nasopharynx is prescribed both for regular examinations and to clarify the diagnosis. A timely examination allows you to identify possible diseases at an early stage of development and begin appropriate treatment. This method is the main way to detect diseases in the practice of ENT specialists.

With the help of endoscopy, the otolaryngologist has the opportunity to carefully examine the internal cavity of the nose at various angles and under magnification. This diagnostic method allows you to identify possible pathologies of the examined organ and make an accurate diagnosis. In particular, this procedure determines:

1. Benign and malignant tumors.
2. Inflammatory processes in the adenoids and maxillary sinuses.
3. Polyps and erosion.
4. Anomalies in the structure of the nose (curvature, perforation)
5. Structural changes in the mucous membrane of the nasopharynx.

Diseases in which it is customary to prescribe endoscopy are quite diverse, these are sinusitis, tonsillitis, sinusitis, frontal sinusitis, ethmoiditis, sphenoiditis. In addition, such a diagnostic procedure is carried out in the presence of certain symptoms, such as:

• difficulty breathing;
• purulent discharge from the nose and nosebleeds;
• frequent headaches;
• hearing problems - hearing loss or tinnitus;
• snore;
• impaired sense of smell;
• ear congestion and hearing loss;
• face pressure.

How is the diagnosis carried out?

Endoscopy is performed using a special device - an endoscope, which is a long thin tube with a diameter of up to 4 mm. The tube has a flashlight and a camera on one end, and an eyepiece on the other.

The procedure does not require any special preparation. It is quite easily tolerated by children, they can carry out endoscopy of the nasopharynx from the age of 3. It is important to morally prepare the patient for the upcoming procedure, with an explanation of its features.

Endoscopy of the nasopharynx is performed under local anesthesia.

Most often, Lidocaine is used for these purposes. For the procedure, the child sits on a chair and tilts his head back a little. After anesthesia, an endoscopic tube is inserted into the nasal cavity. The procedure takes about 20 minutes in duration and includes anesthesia, examination itself, a printout of the obtained images of the nasopharyngeal cavity and a doctor's conclusion.

As part of surgical endoscopy, the doctor removes existing formations in the nasopharynx without affecting other structures of the mucosa of the organ. The advantage of this procedure is the absence of bleeding, scars and scars. In addition, there is no need for a postoperative recovery period. Patient supervision by doctors after the procedure is carried out within one day.

The procedure itself has no contraindications, with the exception of an allergic reaction to an anesthetic drug. In addition, before starting the procedure, it is necessary to notify the doctor about possible features such as mucosal sensitivity. In this case, the doctor will perform endoscopy with a device with a thinner diameter so as not to damage the mucous membrane.

Surgical treatment of diseases

Surgical treatment of diseases of the ENT organs is successfully carried out using an endoscope. This method has been very popular lately. This is due to its effectiveness and lack of side effects. The operation by endoscopic method does not injure healthy tissues of the mucosa and is of good quality.

Removal of adenoids or tonsils in case of relevant diseases is recommended to be carried out with the help of an endoscope. This is due to the fact that in this case there is a full guarantee that all lymphoid tissue will be completely removed, and the disease will not recur. When adenoids or tonsils are removed in the usual way, relapses of the disease often occur, since lymphoid tissue remains in the nasopharyngeal cavity, which subsequently re-grows.

During minimally invasive surgical procedures using an endoscope, not local anesthesia is used, but general anesthesia.

Also, through endoscopic surgery, it is possible to successfully correct the anatomical defects of the nasopharynx, which can provoke chronic inflammatory processes. If such an operation is carried out correctly, then patients who have suffered from inflammatory processes for a long time can quickly get rid of this ailment.

In addition to surgical treatment, conservative treatment can be carried out with an endoscope, for example, washing the sinuses or injecting drugs there. In addition, polyps can be removed endoscopically and material taken for analysis.

Types of pathology

As a standard diagnostic procedure in the practice of ENT diseases, nasal endoscopy is performed in 2 types: anterior and posterior. In most cases, an anterior rhinoscopy is performed. The back is more complex in terms of execution technique. If the patient has mucosal edema or hypertrophy of the palatine tonsils, difficulties in carrying out this procedure are not excluded.

Before proceeding with the anterior endoscopy of the nose, it is necessary to check whether there are abscesses in the cavity of the nasopharynx and whether an inflammatory process has developed.

Anterior nasal endoscopy is performed in two positions of the patient - the head is thrown back and in the usual, normal position. In the first case, the middle sections of the nasal cavity are examined, and the nasal passage is also visible. If the head is in a straight position, then it is possible to examine the anterior sections of the nose and its posterior wall, nasal passage and septum. With a highly qualified doctor, the procedure should not cause discomfort to the patient.

Posterior endoscopy allows you to examine the back of the nose, its sides and vault. To perform a posterior rhinoscopy, you will need a spatula, with which the doctor will move the anterior part of the tongue, and a special mirror inserted into the nasopharyngeal cavity. The mirror is preheated so that it does not fog up during the inspection.

Such an examination is indicated if the patient does not have a gag reflex, and is not performed in the following cases:

• narrow throat;
• hypertrophy of the tonsils;
• too long palatal tongue;
• tumors of the nasopharynx;
• inflammatory processes in the body;
• lordosis of the cervical region;
• cicatricial changes in tissues.

This method of research allows you to accurately diagnose tumors in the sphenoid sinuses and any inflammatory processes. The images obtained with the endoscope are displayed on the machine's monitor screen. According to them, the doctor makes a conclusion, diagnoses and prescribes treatment.

Pediatric endoscopy is fundamentally different from adult endoscopy. The specifics of endoscopic examination of babies are the physiological features of a fragile developing organism:

The small size of the digestive and respiratory organs makes instrumental interventions difficult.

The neuropsychic characteristics of a small child (negative attitude to any medical influences, emotional instability, rapid excitability) create additional difficulties. Therefore, for our patients, endoscopy is possible in a state of moderate sedation.

In the medical center "Best Clinic" the endoscopy room is equipped with ultra-thin endoscopes, which allow performing visual diagnostic examinations even for infants. They are carried out in comfortable conditions for the baby - short-term medical sleep. The procedure demonstrates high efficiency and absolute painlessness.

What types of studies in children are possible with the help of an endoscope

Depending on which specialist you contacted, the following endoscopic examinations are available at the Best Clinic Medical Center:

esophagogastroduodenoscopy (EGDS, FGDS) - the upper parts of the digestive tract (esophagus, stomach, duodenum);

laryngoscopy - larynx;

rhinoscopy - paranasal cavities;

otoscopy - examination of the auditory canals;

also in the medical center "Best Clinic", it is possible to conduct capsule endoscopy - this is a study using a special capsule that the patient swallows and does not experience absolutely any discomfort during the study. The capsule is small in size and can be used in children from 4-5 years old.

At the appointment with a specialist

Reception by the endoscopist of children is carried out in the presence of parents. The procedure is similar to adult endoscopy. What should be the anesthesia, local or general, the doctor decides after an objective examination of a small patient. After immersing the child in drug-induced sleep or performing local anesthesia, the specialist performs the following actions:

The end of the endoscope with a mini-camera is inserted into the cavity of the organ under study. If the digestive tract is being examined, air is pre-inflated into the lumen to smooth out the wrinkles. This makes the inspection more efficient.

When a foreign body is detected, it is removed, and if changes in the mucous membrane are detected, a small cut is made from a suspicious area for further examination under a microscope (biopsy).

An endoscopic procedure can last from 10 minutes to 20 minutes, depending on what goals are being pursued. Each type of endoscopic examination involves specific preparation of the child. The attending physician tells the parents about it when prescribing an endoscopy for the baby, but the main requirement is universal - the cavity to be examined must be completely clean. This is achieved with the help of special cleansing procedures (enemas, nasal lavage, etc.). If this basic requirement is not met, the results of the study will be distorted and unreliable.

Before an endoscopic examination, parents are always given recommendations on how to prepare the baby for the procedure. Each type of endoscopy is different. But there are general tips from endoscopists:

The child should be psychologically adjusted to the procedure.

In the morning, before the endoscopic examination, the child should not eat or drink water.

Parents should tell the doctor if the baby has chronic illnesses and allergic reactions that may affect the course of the study.

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 a 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 edema 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.

When diagnosing pathologies of the nasopharynx, physicians often resort to various research methods, one of which has become endoscopy. Today, the study of the nose in this way is widespread. The method is relatively new, but less traumatic, painless, and as accurate as possible.

The procedure is acceptable even in children. Endoscopy allows you to quickly identify diseases of the nasopharynx, which significantly speeds up the diagnosis of the disease, reduces the time of treatment, minimally affecting the general condition of the patient.

The procedure for endoscopy of the nasal cavity is performed using an endoscope - a device that looks like a thin tube with a thickness from 2 to 4 mm. Visibility is improved with a flashlight built into the device. On the one hand there is a camera, on the other - an oculator. Tubes can be ultra-thin, soft, bendable and rigid.

Endoscope device

Endoscopy as a method of diagnosing the nasal cavity has gained wide popularity, since the procedure allows you to see the inside of the nose in any size from a different angle. Such an examination allows you to establish an accurate diagnosis.

Nasal endoscopy can be combined with surgical intervention. In this case, various neoplasms are removed during the procedure. Healthy tissues and mucous membranes do not suffer. After this, there is practically no bleeding, scars, visible incisions on the face. On the second day after its implementation, the patient is discharged home.

Indications for the procedure

The main indicators by which the otorhinolaryngologist prescribes an examination of the nasal cavity and nasopharynx with an endoscope are the occurrence of certain symptoms indicating the development of possible pathologies.

The main provoking symptoms are:

• breathing problems;
• secretion of mucus, blood from the nasal passages;
• decreased sense of smell,;
• the occurrence of ear noise;
• speech problems (in children);
• pressure, heat covering the facial areas;
• changes in the nasal septum, curvature, trauma;
• snore;
• rhinoplasty;
• injuries of the face, skull;
• headache.

Diseases for which this diagnosis is performed:

The study allows you to identify tumors of a different nature, inflammatory foci, the formation of growths (), violations of the structure of the nasal mucosa.

Contraindications

Doctors say that the main and only contraindication to the study can only be individual intolerance to Lidocaine. Even if the applicant is tormented by constant nosebleeds, the mucous membrane is too sensitive - a special thin tube is selected with the most gentle effect on the cavity from the inside.

How do children do nasopharyngeal endoscopy?

For children, an endoscopic examination of the nasopharynx is most often prescribed when an inflammatory process that has engulfed the adenoids is detected, the development of pathologies of the ENT organs. The procedure allows you to examine the lesions, determine the nature of the discharge on the surface of the diseased organ, see the edema and check the state of the beginning of the auditory canals.

The most important and main stage of preparation for performing an endoscopic examination of the nose is the psychological preparation of the patient, especially if he is a child.

The procedure for children is carried out using a pediatric endoscope - a specially very thin device for examining adenoids in children from 2.5 to 3 years old

Preparation for the procedure

Before the procedure, the specialist conducts a short conversation with the child that during the process you need to sit still, do not twitch, do not scream, so as not to interfere with the doctor and not hurt yourself. The specialist necessarily stipulates that it will not hurt, there is nothing to be afraid of. Having set the child in a positive way, treats the end of the endoscope with a gel containing Lidocaine or uses a spray.

The course of the procedure

The patient is seated in a medical chair, slightly tilting his head up. The procedure begins with the local injection of an anesthetic drug - Lidocaine. As soon as the drug begins its action, the child feels a slight tingling in the nose.

The introduction of the tube into the nasal cavity is performed slowly. A small patient must understand, feel and realize that pain and danger do not arise. In this case, the parents slightly keep the child from possible movements.

As the device is placed into the nasal cavity, an image of everything that “sees” the end of the tube is displayed on the monitor.

An experienced specialist will spend the whole procedure no more than 20 minutes.

In this case, apart from mild discomfort, the patient will not feel anything bad.

At the end of the endoscopy, photographs are printed with the identified deviations from the norm, the doctor draws up a conclusion, diagnosing the pathology.

Where can I do a nasopharyngeal endoscopy?

In a regular clinic, if there is an endoscope in the ENT room, it is quite possible to undergo endoscopy of the nasopharynx. This service is also provided by paid medical organizations - diagnostic centers, sanatoriums.