Advertising on the portal

Where can I do an endoscopy of the nasopharynx for a child? Endoscopic examination of the nasopharynx

This is a technique for examining the nose and nasopharynx, which is the least traumatic and does not cause stress or mental trauma to the person being examined (this is especially important when it comes to examining a child). The need for an endoscopic examination arises in cases where examination with a nasal speculum is not enough for some reason.

What is endoscopy

Thanks to the intensive development of medical technologies endoscopic method quickly became one of the survey standards. Endoscopy is a very informative method of visualizing the structures of the nasal cavity and nasopharynx, allowing one to assess their condition, appearance, and the severity of pathological processes identified during examination.

An endoscope is a small-diameter tube about half a centimeter thick. To perform endoscopy, a rigid (non-bending) or flexible (capable of changing direction) endoscope can be used. Inside the endoscope there is a lighting element and optical system; Such a device makes it possible to examine in detail even corners that are inaccessible for direct inspection.

How is endoscopy done?

Preparation for manipulation

  1. Before inserting the endoscope, the nasal mucosa is irrigated with medication, causing vasoconstriction, as a result of which swelling is significantly reduced and the degree of visibility is increased. In addition, as a result, it becomes possible to insert the endoscope without practically touching the mucous membrane, which reduces the risk of injury.
  2. For the purpose of anesthesia, the mucous membrane is irrigated with any anesthetic. An important point: before using an anesthetic, you must make sure that the patient does not have negative reactions to it (for example, allergic).

Inspection

The patient is in a sitting position, with head thrown back, an endoscope is inserted into the nasal cavity. The procedure begins with an examination of the lower nasal passage, gradually advancing the endoscope to the nasopharynx and gradually examining all anatomical formations.

What is revealed during endoscopy?

This type of examination of the nasopharynx allows one to identify a number of processes without resorting to more traumatic examination methods, which is especially important when it comes to examination of the child.

Indications

With the help of endoscopy, it is possible to examine the inner surface of the nose and nasopharynx at different magnifications and from different viewing angles. This may be necessary for visual detection and diagnosis of various pathologies, as well as removal of foreign objects from the respiratory tract.

The reasons for carrying out this diagnostic procedure are:

  • difficulty breathing;
  • decreased sense of smell;
  • presence of any nasal discharge;
  • nosebleeds;
  • headaches (especially constant, intrusive ones);
  • feeling of pressure in the facial area;
  • suspicion of inflammatory processes in the nasopharynx;
  • complaints of hearing loss or extraneous sounds, tinnitus;
  • in childhood - cases of speech delay;
  • complaints of snoring;
  • sinusitis (frontal sinusitis, sinusitis);
  • hay fever;
  • tonsillitis;
  • injuries of the facial part of the skull;
  • suspicion of a foreign object entering the nasal cavity or nasopharynx;
  • ethmoiditis.

Contraindications

The only absolute contraindication for nasopharyngeal endoscopy is an allergic reaction to the anesthetic used during endoscopy (lidocaine).

Caution must be exercised in cases where it becomes known that the patient has repeated nosebleeds.

Endoscopy of the nasopharynx in a child

Of no small importance when preparing for endoscopic examination in children is the moral preparation of the child for the examination. Although the procedure does not cause significant discomfort, the prospect of manipulating medical instruments may frighten the child. Therefore, before starting the procedure, the child should be properly prepared, explaining to him that nothing terrible is happening and it will not hurt him. If the child does not cry or resist during the examination, the examination will take place in a calm atmosphere and will be more informative.

The most common reason for an endoscopic examination of the nose and nasopharynx in a child is adenoids. Endoscopy of the nose for this pathology allows you to get the most complete picture (unlike an x-ray examination, which does not provide all the necessary information).

Using nasal endoscopy in a child with adenoids, it is possible to obtain the following information:

  • the presence and intensity of the inflammatory process on the nasal mucosa;
  • the presence and nature of pathological discharge on the surface of the adenoids;
  • the presence and severity of edema on the mucous membrane of the nose, nasopharynx and adenoids;
  • condition of the mouths of the auditory tubes.

Another case where endoscopy of the nose and nasopharynx can provide valuable information is when there is a suspicion of a foreign object in the nasal cavity or nasopharynx. In pediatric practice, these are usually small parts of toys. Endoscopic examination allows you to accurately determine the location of the foreign body and the condition of the mucous membrane at the site of its localization (the presence of edema or trauma).

Pediatric endoscopy is fundamentally different from adult endoscopy. The specificity of endoscopic examination of babies is the physiological characteristics of a fragile developing organism:

    The small size of the digestive and respiratory organs makes instrumental types of interventions difficult.

    The neuropsychic characteristics of a small child (negative attitude towards any medical influences, emotional instability, rapid excitability) create additional difficulties. Therefore, for our patients, endoscopy is possible in a state of moderate sedation.

At the Best Clinic medical center, the endoscopy room is equipped with ultra-thin endoscopes that allow visual diagnostic examinations even for infants. They are carried out in conditions that are comfortable for the baby - short-term medicated sleep. The procedure demonstrates high effectiveness and absolute painlessness.

What types of studies in children are possible using an endoscope?

Depending on which specialist you contacted, the following endoscopic examinations are available at the Best Clinic medical center:

    esophagogastroduodenoscopy (EGDS, FGDS) - upper parts of the digestive tract (esophagus, stomach, duodenum);

    laryngoscopy - larynx;

    rhinoscopy - paranasal cavities;

    otoscopy - examination of the ear canals;

    Also at the Best Clinic medical center, it is possible to conduct capsule endoscopy - this is an examination using a special capsule, which the patient swallows and experiences absolutely no discomfort during the examination. The capsule is small in size and can be used in children from 4-5 years of age.

At an appointment with a specialist

Children are seen by an endoscopist in the presence of their parents. The technique for performing the procedure is similar to adult endoscopy. What kind of anesthesia should be, local or general, is decided by the doctor after an objective examination of the small patient. After putting the child into medicated sleep or administering local anesthesia, the specialist performs the following actions:

    The end of the endoscope with a mini-camera is inserted into the cavity of the organ being examined. If the digestive tract is examined, air is first pumped into the lumen to smooth out the folds. This makes the inspection more effective.

    If a foreign body is detected, it is removed, and if changes in the mucous membrane are detected, a small section is made from the suspicious area for further examination under a microscope (biopsy).

The endoscopic procedure can last from 10 minutes to 20 minutes, depending on what goals are being pursued. Each type of endoscopic examination requires specific preparation of the child. The attending physician tells the parents about it when prescribing an endoscopy for the baby, but the main requirement is universal - the cavity that will be examined must be completely clean. This is achieved with the help of special cleansing procedures (enema, nasal rinsing, etc.). If this basic requirement is not met, the research results will be distorted and unreliable.

Before an endoscopic examination, parents are always given recommendations on how to prepare their baby for the procedure. They are different for each type of endoscopy. But there is also general advice from endoscopists:

    The child should be psychologically prepared for the procedure.

    In the morning, before the endoscopic examination, the child should not eat or drink water.

    Parents should tell the doctor about the baby’s chronic diseases and allergic reactions, which may affect the course of the study.

When diagnosing pathologies of the nasopharynx, doctors often resort to various research methods, one of which is endoscopy. Today, examining the nose in this way is widespread. The method is relatively new, but less traumatic, painless, and as accurate as possible.

The procedure is acceptable even for children. Endoscopy allows you to quickly identify diseases of the nasopharynx, which significantly speeds up the diagnosis of the disease, reduces treatment time, with minimal impact on the general condition of the patient.

The procedure for endoscopy of the nasal cavity is performed using an endoscope - a device that looks like a thin tube, thick from 2 to 4 mm. Visibility is improved with the help of a flashlight built into the device. On one side there is a camera, on the other there is an ophthalmologist. Tubes can be ultra-thin, soft, flexible or hard.

Endoscope device

Endoscopy as a method of diagnosing the nasal cavity has gained wide popularity, since the procedure allows you to see the internal nasal cavity in any size from different angles. Such an examination allows you to establish an accurate diagnosis.

Nasal endoscopy can be combined with surgical intervention. In this case, various tumors are removed during the procedure. Healthy tissues and mucous membranes are not affected. After this, there is practically no bleeding, scars, or visible cuts on the face. On the second day after its completion, the patient is discharged home.

Indications for the procedure

The main indicators by which an otorhinolaryngologist prescribes an examination of the nasal cavity and nasopharynx with an endoscope is the occurrence of certain symptoms indicating the development of possible pathologies.

The main provoking symptoms are:

  • breathing problems;
  • discharge of mucus and blood from the nasal passages;
  • decreased sense of smell;
  • the occurrence of ear noise;
  • speech problems (in children);
  • pressure, heat covering the facial areas;
  • changes in the nasal septum, curvature, trauma;
  • snore;
  • rhinoplasty;
  • injuries to the face, skull;
  • headache.

Diseases for which this diagnosis is performed:

The study allows us to identify tumors of various types, inflammatory foci, the formation of growths (), and disturbances in the structure of the nasal mucosa.

Contraindications

Doctors say that the main and only contraindication to the study can only be individual intolerance to lidocaine. Even if the applicant suffers from constant nosebleeds, the mucous membrane is too sensitive - a special thin tube is selected with the most gentle effect on the cavity from the inside.

How do children undergo nasopharyngeal endoscopy?

For children, endoscopic examination of the nasopharynx is most often prescribed when an inflammatory process involving the adenoids or the development of pathologies of the ENT organs is detected. The procedure allows you to examine the lesions, determine the nature of the discharge on the surface of the diseased organ, see the swelling and check the condition of the beginning of the auditory canals.

The most important and basic stage of preparation for an endoscopic examination of the nose is the psychological preparation of the patient, especially if he is a child.

The procedure for children is carried out using a children's endoscope - a specially very thin device for examining the adenoids of children from 2.5 to 3 years old.

Preparing for the procedure

Before the procedure, the specialist conducts a short conversation with the child. that during the process you need to sit quietly, not twitch, not scream, so as not to disturb the doctor and not cause yourself pain. The specialist must stipulate that it will not hurt, there is nothing to be afraid of. Having set the child in a positive mood, he treats the end of the endoscope with a gel containing Lidocaine or uses a spray.

Progress of the procedure

The patient is seated in a medical chair with his head tilted slightly upward. The procedure begins with the local administration of an anesthetic drug – Lidocaine. As soon as the medication begins to take effect, the child feels a slight tingling sensation in the nose.

The tube is inserted into the nasal cavity slowly. The little patient must understand, feel and realize that pain and danger do not arise. At the same time, parents slightly restrain the child from possible movements.

As the device is placed into the nasal cavity, the monitor displays an image of everything that the end of the tube “sees.”

An experienced specialist will spend the entire procedure no more than 20 minutes.

In this case, other than mild discomfort, the patient will not feel anything bad.

At the end of the endoscopy, photographs are printed with detected deviations from the norm, and the doctor draws up a conclusion diagnosing the pathology.

Where can I get a nasopharyngeal endoscopy?

In a regular clinic, if there is an endoscope in the ENT office, it is quite possible to undergo endoscopy of the nasopharynx. This service is also provided by paid medical organizations - diagnostic centers, sanatoriums.

Hi all! My review today will be useful to parents whose children have been diagnosed with Adenoiditis. I will tell you in detail about a unique procedure with which you can examine the nasopharynx of any person “from the inside” in a minute.

My daughter is 3 years and 8 months old; we were diagnosed with adenoiditis 8 months ago. Moreover, we somehow flew through the first two stages of the disease at the speed of sound, instantly receiving the third, most unpleasant one.

Adenoiditis in our case is a consequence of a previous EBV infection. After endless ARVI and runny noses, our pediatrician strongly recommended doing an endoscopy of the adenoids in order to determine the extent of the disease and determine treatment. With the third degree, surgery to remove the adenoids is indicated.

In our city, endoscopy is performed for children in two clinics: the regional children's hospital and the Constanta clinic. The study is paid and costs 550 rubles.

The VodKB was very surprised when they learned that I wanted to do an endoscopy on a three-year-old child. They don’t do it until they are 4 years old. At the reception I heard: What are you talking about, it’s painful, the baby won’t survive!

I admit, my ardor has subsided...

But the pediatrician insistently sent me to Constanta, and I called. There they assured me that the procedure was absolutely painless, and the doctor had experience in performing endoscopy on children from 2 years old. And I decided!

So, my impressions: a very competent and attentive doctor who immediately found an approach to the Child.

Procedure steps:

First, an anesthetic spray is sprayed into the nose. So that the child does not get scared, they spray it on themselves, their parents, and all the toys in the office. We had a great time

then vasoconstrictor drops according to the same principle

Then we wait 3 minutes for the anesthesia to take effect and the procedure itself begins.

An endoscope is inserted into the nose; it is metal, not flexible, with a camera and a light bulb at the end. It is very important to sit still, because there is a risk of tissue injury if the child twitches.

The doctor worked perfectly, 100%! The daughter looked at the screen, where the parents were shown the contents of the nasopharynx with magnification, and did not move. They also looked at our ears as a bonus, because the adenoids started causing problems with our left ear.

As a result, grade 3 adenoids. The child tolerated the procedure perfectly, without experiencing the slightest discomfort.

And yesterday we repeated the study, but in a children's hospital. Why? Because I wanted to get a consultation from the doctor who performs operations to remove adenoids.

Differences from the first survey:

The spray is sprayed into the nose from a huge iron device with a sharp long tip. The daughter instantly got scared and started screaming and struggling. It was impossible to numb my nose; I had to call my husband and a nurse for help. The three of us held the child, because it was not possible to come to an agreement with her. The doctor demonstrated complete indifference to what was happening.

Endoscope without camera, only flashlight. There was nothing to distract the child, she was screaming in horror.

Now I understand why they don’t do endoscopy for children under 4 years old.

But our suffering was not in vain: the adenoids have shrunk to grade 2, the dynamics are positive, and surgery is not required yet.

Advice for parents before undergoing the examination:

Choose your clinic and doctor carefully! You don’t need a world luminary academician, you need a very competent psychologist who can come to an agreement with the child. And then go to the academician with the results.

Tell the Child what will be done to him, explain that it is not painful, but very interesting.

Be calm yourself: sometimes this is the most difficult thing)))