Upper respiratory tract fiberscopy is an examination which lets an ENT specialist see and evaluate potential changes to hard-to-access areas of the respiratory tract. It is the endoscopic examination performed with the use of a flexible endoscope with a camera and light at the tip.
Although Hippocrates described endoscopic examination of respiratory tract as early as in the 5th century BC, in 1954 Harold Horace Hopkins developed a flexible endoscope (fiberscope) to start a new era in ENT diagnostics.
ENT FIBERSCOPE - STRUCTURE
Fiberscopes are made of combined flexible optical-fibers some of which conduct light towards the area in question, while others image towards the camera or the doctor.
Years of image and lighting improvements have led to increase in quality of fiberscopic examinations. Thanks to equipment miniaturization, even small children may be examined.
Upper respiratory tract fiberscopy - recommendations
Upper respiratory tract fiberscopy is an endoscopic examination allowing a wide range of applications. Both adults and children may undergo the examination. At present a fiberscopic examination is perceived to be the so-called gold standard in the process of examining patients who have the following symptoms:
- Nose obstruction,
- Breathing disorder while sleeping,
- Snoring, hearing loss.
The examination is performed in order to diagnose palatine tonsils, perform a detailed assessment of nasopharynx, lower part of the pharynx and larynx, and as a follow-up examination after many treatments, e.g. third tonsil surgery.
DIAGNOSING CAVITY AND NASOPHARYNX PATENCY
Upper respiratory tract fiberscopy in Warsaw performed in Damian Hospital is an endoscopic examination intended to diagnose cavity and nasopharynx patency. This allows a precise assessment of nasal septum, its curvature, quality of mucous membrane, size of nasal conchas and their influence on potential nasal cavity obstruction. During the examination, it is possible to examine paranasal sinuses passages while after functional sinus surgeries – see the inside of paranasal sinuses.
The nasal cavity endoscopic examination helps doctors detect polyps emerging in the process of mucous membrane inflammation, hypertrophied changes, tubers, post-surgical adhesions. In some cases it is possible to get samples for the purposes of the histopathological examination.
By inserting the fiberscope deeper, we enter the nasopharynx.
Speaking of children, the nasopharynx evaluation is intended to confirm or exclude the presence of pharyngeal tonsil (the so-called third tonsil) and its impact on ear trumpet, and thus loss of hearing among children suffering from palatine tonsil hypertrophy. This examination requires a child to cooperate and may be a little difficult if the child is restless.
A nasopharynx fiberscopic evaluation among adults is performed in order to diagnose breathing disorders during sleep (we frequently diagnose a pharyngeal tonsil, that is the third tonsil which blocks the rear nostrils). It is also recommended as a diagnostic examination with regard to conductive hearing loss, ear trumpet obstruction, diagnosing nasopharynx cancer. It is very difficult to examine this area without the endoscope – fiberscope.
DIAGNOSING LOW PHARYNX AND LARYNX
A fiberscopic method is used to diagnose persons who suffer from voice disorders, have a sore throat, swallowing complaints, feeling of obstruction in the pharynx, suspicion of a foreign body, chronic pain in the pharynx area.
A flexible fiberscopy disturbs a speech generation process to a minor extent and this is why it can be used in phoniatric diagnostics. It can be useful in the process of assessing dynamic changes, such as paresis or vocal cords paralysis. This examination allows a precise assessment of the width of rima glottidis, presence of surplus of tissue, polyps or vocal fold nodules. It allows early identification of tubers, larynx cancers among patients suffering from voice disorders.
Fiberscopy facilitates a precise evaluation of changes in the lower area of the pharynx, vallecula, piriform recess. In these hard-to-examine areas there might be proliferative changes, or foreign bodies which are invisible during a routine examination with the use of indirect laryngoscopy.
WHAT IS A FIBERSCOPIC EXAMINATION LIKE?
The fiberscopic examination is performed in a sitting position. Although it does not require a general anesthesia, a patient is usually anesthetized locally. The area in question can be observed in the screen.
A flexible fiberscope adapts to natural curvatures in the area of the respiratory tract. In effect, the access to all areas, including hard-to-access areas, is possible and painless. This a-few-minute examination helps a doctor to make a diagnosis earlier.
To perform the endoscopic examination, that is an upper respiratory tract fiberscopy, in Warsaw, arrange a visit now in Damian Hospital.
Iwona Olędzka – ENT specialist