Diagnostic endoscopy of the nose

Abstract

The purpose of this presentation is to describe a diagnostic technique of examining the nasal cavity with nasal endoscopes. This technique is used for the identification and evaluation of structural abnormalities and chronic inflammatory changes which may be medically treated or surgically repaired. The rigid endoscopes with angled lenses allow elevation of the middle turbinate and direct inspection of the middle meatus and ostiomeatal complex. Passage of the endoscope medial to the middle turbinate allows inspection of the sphenoid recess and nasopharynx. Maxillary sinusoscopy can be performed through a trochar placed sublabially through the anterior face of the maxilla. It is a valuable technique for evaluation and biopsy of maxillary sinus lesions. Endoscopic ethmoidectomy combined with maxillary sinusoscopy have largely replaced Caldwell-Luc procedures at our institution. An invaluable asset in the evaluation of the sinuses is the coronal CT scan. This scan, in contrast to axial scans, is done in the same orientation as the endoscopic examination. It not only demonstrates pathology within the sinuses, which cannot be directly examined, but also confirms the endoscopic observations of the shape and condition of the ostiomeatal complex.