Endoscopic evaluation of the nasal and paranasal sinus cavities is a specialized examination that allows for precise visualization of structures inside the nose and paranasal sinuses. It is a commonly used diagnostic method in otorhinolaryngology, especially in patients with chronic sinus problems, allergies, nasal polyps, recurrent infections or breathing difficulties.

What is endoscopic evaluation of the nasal cavities and paranasal sinuses?

1. Preparation for the examination:
   • Local anesthesia is typically used in the form of an anesthetic spray or gel that is applied to the nose to reduce discomfort.
   • In some cases, your doctor may also use nasal decongestants before the examination to help with better visibility.
2. Course of the study:
   • The doctor inserts a thin, flexible or rigid endoscope through the patient's nostril. The endoscope is equipped with a camera and a light source, which allows for precise visualization of the inside of the nose and sinuses.
   • The endoscope allows the doctor to view:
   • Nasal septum,
   • Nasal turbinates,
   • The openings of the paranasal sinuses,
   • Presence of polyps, tumors, infections or swelling.
   • The examination usually takes a few minutes and allows the doctor to locate any pathological changes, such as nasal polyps, purulent discharge, sinus stenosis, or other abnormalities.
3. Assessment of the paranasal sinuses:
   • Although direct visualization of the sinuses with an endoscope may be limited (except for the sinus openings), the physician can closely examine the sinus openings into the nasal cavity. This can identify obstructions to the drainage of sinus secretions, such as polyps, swelling, or infections.

Indications for nasal and sinus endoscopy:

• Chronic or recurrent sinusitis: In patients who suffer from long-term sinus symptoms such as headache, nasal obstruction, or purulent discharge, endoscopy allows for the assessment of the condition of the mucous membranes and the presence of lesions such as polyps.
• Suspected nasal or sinus polyps: Polyps are soft growths that can block airflow in the nose and sinuses, leading to difficulty breathing and chronic infections.
• Deviated nasal septum: This test allows for the assessment of the degree of deviation of the nasal septum and its effect on airflow.
• Cysts, tumors: Endoscopy allows for early detection of neoplastic lesions, cysts, or other pathologies that may require further treatment.
• Postoperative evaluation: After nasal or sinus surgery, endoscopy is used to monitor the condition of the nasal cavities, check for adhesions, and assess the effectiveness of treatment.
• Advantages of endoscopic evaluation of the nasal cavities and paranasal sinuses:
• Precise diagnosis: Allows for a detailed examination of the inside of the nose and sinus openings, which is impossible with a standard nasal examination.
• Minimally invasive: The test is minimally invasive and usually does not cause significant discomfort.
• Sample collection options: During the examination, a tissue sample may be collected for histopathological examination or culture if a bacterial or neoplastic infection is suspected.

Risks and contraindications:

• The examination is generally safe, but may be associated with mild discomfort, nosebleeds (especially in people with delicate nasal mucosa) or a burning sensation after the anesthetic is administered.
• It is not recommended for people with acute inflammation of the nose or sinuses, then it may be necessary to postpone the examination until the inflammation subsides.

Endoscopy of the nose and paranasal sinuses is an extremely effective diagnostic method that allows for early detection of many diseases and a precise assessment of the structure of the nose and sinuses.