Nasal Endoscopy

What is a nasal endoscopy?

A nasal endoscopy, also called a rhinoscopy or nasoendoscopy, is a procedure to look inside your nose, sinuses and sometimes the back of your throat and voice box. Your doctor passes a thin tube called an endoscope through your nostril, which has a light and a tiny camera on the end, giving a clear, magnified view on a screen.

Why might I need one?

Your doctor may suggest a nasal endoscopy to help diagnose persistent symptoms such as:

• a loss of your sense of smell
• facial pain, especially above your eyes or around your sinuses
• nasal congestion or blockage
• nosebleeds
• sinus headaches

It's also a standard part of investigating symptoms that could be linked to head and neck cancer, and your doctor may use it to check for growths, take a biopsy, carry out sinus surgery, or remove a foreign object from your nose.

What are the benefits of having it?

A nasal endoscopy gives your doctor a detailed, magnified view of areas that can't be properly seen with a standard examination. It's quick, can usually be done in the same appointment as your initial consultation, and helps your doctor reach an accurate diagnosis without needing further imaging in many cases.

Are there different types of the test?

There are two main types of endoscope used:

• flexible nasal endoscopy: uses a thin, bendable tube, often used to look further back towards the throat and voice box, for example if you have a hoarse voice, difficulty swallowing, or a suspected problem with your vocal cords
• rigid nasal endoscopy: gives a particularly clear, detailed view of the nose and sinuses themselves, often used for a blocked nose, loss of smell, facial pain, or suspected sinusitis

Your doctor will choose whichever is most appropriate for your symptoms.

How do I prepare for the test?

You don't usually need to do anything special to prepare. You can eat, drink and take your medicines as normal beforehand. If you take blood-thinning medication, mention this to your doctor. It's rarely necessary, but you might occasionally be asked to pause this temporarily.

What happens during the test?

1. A decongestant spray may be used to reduce swelling and open up your nasal passages.
2. You'll be offered a local anaesthetic spray to numb your nose, sometimes applied around 10 minutes beforehand, though many people find they don't need this.
3. Your doctor gently passes the endoscope through one of your nostrils.
4. You may be asked to swallow, breathe through your nose, or puff out your cheeks, so your doctor can see different areas clearly.
5. Your doctor examines your nose, sinuses and, if needed, your throat and voice box, sometimes repeating the process on the other side.
6. If anything needs immediate attention, such as a biopsy, this can sometimes be done at the same time.

You'll be awake throughout and able to talk to your doctor. The examination itself is usually over within a few minutes, and sometimes takes less than one.

What happens after the test?

You can usually go home straight away. If you had a numbing spray, avoid eating or drinking until the feeling in your mouth and throat has returned to normal, which can take anywhere from 20 minutes to an hour.

Your doctor may be able to discuss what they've found with you on the same day. If they spot something that needs a closer look, you may need to come into hospital for a day case procedure under a short general anaesthetic, so a small sample of tissue can be taken and sent for testing. Occasionally, further imaging such as a CT scan is arranged to get more information.

What are the risks or side effects?

Nasal endoscopy is a very safe procedure. During or shortly after it, you might notice:

• mild discomfort or pressure, and a feeling of something in your throat
• watery eyes or a brief urge to cough
• a mild nosebleed
• some soreness in your nose and throat for a day or two afterwards

Rarer risks include an allergic reaction to the anaesthetic or decongestant spray, fainting, or infection. In children, the procedure can occasionally trigger a breath-holding episode, so it's carried out in a setting with staff and equipment on hand to help if needed.