|  | | | Laryngo-Rhinoscopy |  |
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Simply stated, fiberoptic rhinoscopy is a new
technique for examing the nose and throat.
When you visit your primary doctor and he/
she examines your nose and throat, only the
front portion can be seen. Many diagnoses
can be made by examining this area. But as
we all know, complaints of nasal congestion,
postnasal drainage, itching, bleeding and
pain can occur further back in the nose and
certainly down the throat. An infection can
cause laryngitis and make our voices hoarse.
Ears may pop, ring, and hearing may be
decreased, even if your ears and eardrums
appear normal. An infection or asthma may
cause swallowing and upper airway breathing
to be difficult. With the rhinoscope we can
examine the entire nasal passage, including
the Eustachian Tube openings of the ear
canal to the throat. We can also examine the
tonsils and adenoids to determine size or
look for infection, and be sure that the vocal
cords are normal without nodules or
blockage. We can also check the back of the
throat above the vocal cords for signs of acid
reflux (gastroesophageal reflux or GERD), a
common trigger of asthma and one of the
most common causes of chest pain.
Allergists and ENT doctors are the specialists
trained to use rhinoscopes. Although not
difficult, the procedure takes a few minutes;
if the practice is busy, it may be necessary to
schedule a separate appointment for the
examination.
What is a rhinoscope and how is it used?
The rhinoscope is a small, flexible plastic
tube with fiberoptics for viewing the airway.
The rhinoscope can be attached to a
television camera to provide a permanent
record of your examination. To do the exam,
a decongestant (usually Afrin) is sprayed into
the nose first, followed by a local anesthetic
(usually lidocaine) to numb the area. As the
scope enters the nose, you will feel that it's
there and a little uncomfortable, but it won't
hurt. During the examination of the nose,
you may breathe through the nose or mouth,
but when it's time to look at the back of the
throat and vocal cords, we will ask you to
breathe through the nose, and not to
swallow. Swallowing at this point won't be
dangerous, but could be
uncomfortable.Sometimes the lidocaine drips
down the back of the nose and numbs the
throat; this usually goes away in a few
minutes.
Can children be examined?
Almost nothing that happens in a doctor's
office is popular with small children, and
rhinoscopy is no exception. Older children
put up with the procedure better than do
some adults. With small children, it's best to
ask the child to sit in a parent's lab. If the
child is uncooperative and the exam is
absolutely essential, sedation can be
provided, but you will need to wait in the
practice until the sedative has worn off.
What if you have asthma?
Rhinoscopy can be performed if you have
asthma, but it is best for your breathing to
be well controlled at the time of the exam.
You should continue taking your
medications. Recently, doctors have
discovered an unusual disorder of the larynx
and vocal cords which mimics asthma.
Patients may have an asthma attack with a
croupy sounding bark or cough, and may
even visit the emergency room for help.
Interestingly, medications used to treat
asthma don't work well, and breathing tests
in the allergists office suggest the upper
airway and vocal cords are involved.
Rhinoscopy can then be used to examine
these airway and cords and make the
diagnosis. The easiest may to make the
diagnosis is to examine the vocal cords with
the rhinoscope during an actual attack!
If any abnormality is found that is not likely
to respond to medication, or if we have
questions about your examination, you will
be referred to an ENT specialist. This is the
best approach for both you and your child,
and will address all of your questions and
concerns. |
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Hoboken Allergy & Asthma Specialists, LLC: - Rhinoscopy
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