Nasal Endoscopy

Nasal endoscopy is a procedure in which a doctor uses a thin, flexible or rigid tube fitted with a tiny camera and light — called an endoscope — to look directly inside the nose and the connected spaces behind it.

The endoscope is gently guided through one or both nostrils, giving the doctor a clear, magnified view of the nasal passages, the sinuses (air-filled pockets in the skull bones around the nose), and the back of the throat and voice box. This lets the doctor spot problems that cannot be seen from the outside or with a simple flashlight examination.

Doctors recommend nasal endoscopy when symptoms in the nose, sinuses, or upper airway need a closer look than a standard examination can provide. It is used both to find out what is causing a problem and to check how well a previous treatment has worked.

• Chronic sinusitis (long-lasting inflammation of the sinuses) that does not improve with medicine
• Recurrent or severe nosebleeds (epistaxis) to find the exact source of bleeding
• Nasal polyps (soft, painless growths inside the nose) that block breathing or smell
• A blocked or stuffy nose when the cause is not obvious
• Loss of smell or reduced sense of smell
• Thick nasal discharge or post-nasal drip (mucus dripping down the back of the throat) that persists
• Suspected foreign body inside the nose, especially in children
• Growths, lumps, or tumours in or around the nasal cavity
• Monitoring after sinus surgery to check healing and remove crusting

Nasal endoscopy is generally safe for most people. However, your doctor will weigh up the benefit if you have very narrow nasal passages, a recent facial injury, or a bleeding disorder (a condition that makes blood slow to clot), as these may call for extra precautions or a different approach.

Nasal endoscopy is a low-risk diagnostic procedure and most people tolerate it well with only minor, short-lived discomfort. Serious complications are uncommon.

• Temporary discomfort or a feeling of pressure inside the nose during the examination
• Brief nosebleed after the endoscope is removed, usually stopping on its own within minutes
• Sneezing or watery eyes triggered by the instrument passing through sensitive nasal tissue
• Mild swelling of the nasal lining that settles quickly
• Reaction to the local anaesthetic spray (numbing spray) used to reduce discomfort — usually limited to a bitter taste or mild throat numbness
• Very rarely, a small scratch or nick to the nasal lining, which heals without treatment in most cases

Because nasal endoscopy is a short outpatient examination — not a surgical operation — preparation is minimal. You usually do not need to fast beforehand, and you can take your regular medications unless your doctor specifically asks you to pause any of them. Tell your doctor about all medicines you take, including blood thinners, as these may sometimes need to be temporarily stopped. Also mention any known allergies, particularly to anaesthetic agents.

Your doctor may ask you to avoid decongestant nasal sprays or other nose drops for a day or two before the procedure, so that the nasal lining is in its natural state and easier to assess. Smoking and alcohol do not usually need to be stopped before this examination, but your doctor will give you specific guidance if your case is different.

Tests that are sometimes arranged beforehand include:

• A CT scan of the sinuses, if chronic sinusitis or a structural problem is suspected, so the doctor can review the images alongside the endoscopy findings
• Allergy skin tests or blood tests if allergic rhinitis (hay fever causing persistent nasal symptoms) may be contributing to your condition
• A blood clotting test if you have a history of easy bleeding

On the day of the procedure, the typical steps are:

• You sit in a reclined chair or examination couch in the clinic room.
• The doctor sprays a decongestant and a local anaesthetic (numbing) agent into your nostril to shrink the nasal tissue and reduce any discomfort.
• You wait a few minutes for the spray to take effect.
• The doctor gently inserts the endoscope into one nostril and advances it slowly, pausing to look at each area of the nasal passage and sinus openings.
• You are asked to breathe through your mouth and stay as still as possible.
• The doctor may take still images or a short video recording for your medical record.
• If a small tissue sample (biopsy) is needed, a tiny instrument is passed alongside the endoscope to collect it — your doctor will tell you in advance if this is planned.
• The endoscope is withdrawn and the examination is complete, usually in under fifteen minutes, though the total time in the clinic will be longer.

Recovery after nasal endoscopy is quick. Most people leave the clinic within a short time and go straight home without needing anyone to drive them, although bringing a companion is always sensible. Any numbness from the anaesthetic spray usually wears off within thirty to sixty minutes, and you can eat and drink normally once the numbness has gone.

• Avoid blowing your nose hard for a few hours after the procedure to reduce the small chance of a nosebleed.
• Some mild stuffiness or a slight blood-tinged discharge from the nose on the same day is normal and usually settles without treatment.
• If a biopsy was taken, your doctor will tell you how long to avoid strenuous activity — this is typically a day or two.
• Contact the clinic if you have a nosebleed that does not stop after gentle pressure, a high fever, or increasing pain, as these are signs that need medical review.
• Your doctor will discuss the endoscopy findings with you at the same visit or at a follow-up appointment; if images or biopsy results were taken, results may take a few days to be available.
• If treatment — such as sinus surgery or medicines — is recommended based on the findings, your doctor will explain the next steps at that follow-up.