A lot is assumed, but little is known, about ear, nose and throat endoscopy. Many medical specialists use endoscopes to visualize areas that are difficult or impossible to examine with the naked eye. Most of the time, scopes are used to place the physician's eye directly at the site to be examined. Because the image passes through the fiber optic cables unchanged, hard to reach locations are essentially placed directly in front of the examiner. Light is another advantage. Usually, hard to reach locations are dark. The endoscope floods the area with light, making hidden areas visible. Some scopes can also magnify the view, making smaller structures visible. The physician will use endoscopes to supplement the basic examination. Some diagnoses are impossible to make without endoscopy. Some treatment plans are impossible to make without endoscopy. Sometimes, insurance plans may place an extra co-pay or a charge on endoscopic examinations. To some patients, endoscopes may look scary, but they are very safe. In some specialties, endoscopic examinations may require sedation or general anesthesia. However, in the ear, nose and throat world, endoscopic examinations are very easy. They do not require sedation. Sometimes, topical numbing sprays can be used, but often, no numbing is necessary at all.
So, let's describe a few ear, nose and throat scopes that you might encounter. The simplest to understand is the otologic microscope. While not technically an endoscope, it is basically a microscope used to examine the ears. The scope provides light and magnification, and it allows procedures to be performed in the ears with less pain and less potential for injury. Sometimes, actual endoscopes can be used in the ear canals, as well, to better visualize the eardrum. Next, there is the nasal endoscope. It is the workhorse of the ear, nose and throat office, and the most commonly used scope. It allows visualization of dark areas in the nose, which the physician cannot see with a headlight. It is necessary to evaluate stuffy nose, runny nose, nasal allergies, septal deviations, turbinates, sinus infections, sinus headaches, nosebleeds, nasal polyps, and nasal cancers. The nasal endoscope is a long, silver, rigid scope with an eyepiece at one end and a light at the other. Generally, it does not require numbing, as there is virtually no pain and no risk to the procedure. Next, there is the flexible laryngoscope. It allows visualization of the dark areas in the throat, which the physician cannot see with a headlight. It is necessary to evaluate sore throat, hoarseness, trouble swallowing, chronic cough, sleep apnea, adenoids, ear pain, vocal problems and throat cancers. The flexible laryngoscope is an even longer, black, flexible scope with an eyepiece at one end and a light at the other. Generally, it requires decongestion and numbing with topical sprays to prevent gagging, but it can be done without spraying if the patient prefers. Again, there is no risk to the procedure.
A patient with any of the above symptoms can expect an endoscopy as part of their basic examination. It may be performed at the initial visit or at the follow up visit, depending on the circumstances. Don't let the internet scare you. Most endoscopies can be performed so easily, you may not even notice or remember, but the information obtained is extremely valuable in treating you properly.
Timothy A. Queen, MD is a board certified otolaryngologist and a fellowship trained otolaryngic allergist. He owns Advanced ENT & Allergy, in Oyster Point of Newport News. Please call 757-873-0338 for an appointment. You can also visit online at www.entallergy1.com.
