Rejuvenating The Shunned Art of Diagnostic Nasal Endoscopy Using Angled Endoscopes- A Descriptive Study
Life Sciences-Health
DOI:
https://doi.org/10.22376/ijpbs/lpr.2022.12.6.SP25.L109-115Keywords:
Endoscope, Diagnostic Nasal Endoscopy, Angled Endoscopes, Anatomical Variants, Disease MarkersAbstract
Nasal endoscopy is a minimally invasive, routine outpatient diagnostic procedure. With 0 degree scope being used as the first and often only endoscope in diagnostic nasal endoscopy, this study will explicate use of angled scopes to identify anatomical variants and common disease pointers. A Cross-sectional descriptive study involving 756 subjects, between age group of 12-80 years with chronic nasal complaints. All subjects underwent diagnostic nasal endoscopy with 0-, 30- & 70-degree endoscopes. Common anatomical variants along with disease markers were identified. Anatomical variants embedded in lateral wall of nose such as accessory maxillary ostium (AMO) & medialized uncinated (MU), were seen better on 30 & 70 degree scopes (AMO -12% & 12.8% respectively & MU -7.6 and 8.1% of study population respectively), when compared to 0 degree scopes (AMO-5.6% & MU-7 %). Disease pointers projected a general trend of being better visualized on angled scopes of 30 & 70 degree endoscopes. It included discharging meati (27.9 % & 26.3% subjects on 30 & 70 degree vs 25 % subjects on 0 degree), polyposis (20.2 & 19.6% on 30 & 70 degree vs 13% on 0), eschar (6.1% & 5.7% on 30 & 70 degree vs 4.5% on 0), CSF rhinorrhoea (1.3% & 2.1% on 30 & 70degree vs 0.5% on 0). With inclusion of angled scopes in routine nasal endoscopies, one gains capability to diagnose early disease processes, mucosal changes and learn intra nasal anatomy better. The angulation of lenses provides a better field of vision with appropriate magnification and illumination.
References
Tajudeen BA, Suh JD. Role of Rhinopharyngoscopy in diagnosis of Rhinopathies. Curr Allergy Asthma Rep. 2015 Aug;15(8):45. doi: 10.1007/s11882-015-0551-z, PMID 26149589.
Villwock JA, Kuppersmith RB. Diagnostic algorithm for evaluating nasal airway obstruction. Otolaryngol Clin North Am. 2018 Oct;51(5):867-72. doi: 10.1016/j.otc.2018.05.002, PMID 30057071.
Chainansamit S, Chit-Uea-Ophat C, Reechaipichitkul W, Piromchai P. The diagnostic value of traditional nasal examination tools in an endoscopic era. Ear Nose Throat J. 2021 Mar;100(3):167-71. doi: 10.1177/0145561319875711, PMID 31547699.
Shelkar R, Vedi J, Patel S, Dasgupta K, Lanjewar K. Role of nasal endoscopy in sinonasal diseases. An Int J Clin Rhinol. 2015 Apr;8(1):8-11. doi: 10.5005/jp-journals-10013-1220.
Chandra RK, Conley DB, Kern RC. Evolution of the endoscope and endoscopic sinus surgery. Otolaryngol Clin North Am. 2009 Oct;42(5):747-52. doi: 10.1016/j.otc.2009.07.010, PMID 19909855.
Bhalla V, Beahm DD, Sykes KJ, Ndeti KK, Chiu AG. The impact of video nasal endoscopy on patient satisfaction. Int Forum Allergy Rhinol. 2018 Jun;8(6):737-40. doi: 10.1002/alr.22100, PMID 29457873.
Stankiewicz JA, Chow JM. Nasal endoscopy and the definition and diagnosis of chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2002 Jun;126(6):623-7. doi: 10.1067/mhn.2002.125602, PMID 12087328.
Tyagi S, Srivastava M, Singh V. Diagnosis of chronic rhinosinusitis: can nasal endoscopy be the new gold standard in developing countries? Int J Otorhinolaryngol Head Neck Surg. 2016 Jan 7;2(1):30. doi: 10.18203/issn.2454-5929.ijohns20160066.
Lohiya SS, Patel SV, Pawde AM, Bokare BD, Sakhare PT. Comparative study of diagnostic nasal endoscopy and CT paranasal sinuses in diagnosing chronic rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2016 Jun;68(2):224-9. doi: 10.1007/s12070-015-0907-7, PMID 27340642.
K Maru Y, Gupta Y. Gupta Y. Nasal endoscopy versus other diagnostic tools in sinonasal diseases. Indian J Otolaryngol Head Neck Surg. 2016 Jun;68(2):202-6. doi: 10.1007/s12070-014-0762-y, PMID 27340637.
Joshi S, Telang R, Tambe M, Havaldar R, Sane M, Shaikh A, et al. Outbreak of mucormycosis in coronavirus disease patients, Pune, India. Emerg Infect Dis. 2022 Jan;28(1):1-8. doi: 10.3201/eid2801.211636, PMID 34586055.
Kamath S, Kumar M, Sarkar N, Ahmed T, Sunder A. Study of profile of mucormycosis during the second wave of COVID-19 in a tertiary Care Hospital. Cureus. 2022 Jan;14(1):e21054. doi: 10.7759/cureus.21054, PMID 35155019.
Kishore K, Badial V, Luthra D, Jamwal P. Pattern of abnormal findings in adult with nasal obstruction on rhinoscopy and nasal endoscopy.
Deosthale NV, Khadakkar SP, Harkare VV, Dhoke PR, Dhote KS, Soni AJ, et al. Diagnostic accuracy of nasal endoscopy as compared to computed tomography in chronic rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2017 Dec;69(4):494-9. doi: 10.1007/s12070-017-1232-0, PMID 29238680.
Nathan K, Majhi SK, Bhardwaj R, Gupta A, Ponnusamy S, Basu C, et al. The role of diagnostic nasal endoscopy and a computed tomography scan (nose and PNS) in the assessment of chronic rhinosinusitis: A comparative evaluation of the two techniques. Sinusitis. 2021 Mar 2;5(1):59-66. doi: 10.3390/sinusitis5010007.
Kim HU, Kim SS, Kang SS, Chung IH, Lee JG, Yoon JH. Surgical anatomy of the natural ostium of the sphenoid sinus. Laryngoscope. 2001 Sep;111(9):1599-602. doi: 10.1097/00005537-200109000-00020, PMID 11568612.
Gupta T, Aggarwal A, Sahni D. Anatomical landmarks for locating the sphenoid ostium during endoscopic endonasal approach: a cadaveric study. Surg Radiol Anat. 2013 Mar;35(2):137-42. doi: 10.1007/s00276-012-1018-8, PMID 22968633.
Published
How to Cite
Issue
Section
Copyright (c) 2022 Shashwat Datt Mehta, Karthikeyan P, Vijayasundaram S

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.