What is a nasal endoscopy?

Nasal endoscopy is an endoscopic procedure performed by an otolaryngologist ( Ear, Nose, and Throat Specialist) for the purpose of viewing the structures inside the nose and sinuses. The procedure can be accomplished using either a flexible fiber optic endoscope or a rigid endoscope. A flexible fiber optic endoscope can more easily navigate tighter spaces due to it's typically smaller diameter, but requires both hands for operation. A rigid endoscope has traditionally offered superior image quality, and allows the physician to obtain tissue and culture samples as well as potentially perform surgery in some cases.

What is nasal endoscopy used for?

The most common reasons nasal endoscopy will be performed is in the diagnosis of medical problems such as stuffiness or obstruction in the nasal passages, sinusitis, nasal polyps, nasal tumors, and epistaxis (nose bleeding). Nasal endoscopy can help to determine if the cause of your symptoms are due to infection, inflammation, or an allergic reaction. Symptoms that a patient may seek help for include, for example, drainage of mucous, facial pain or pressure in the area of the sinuses, nasal obstruction, congestion, or a decrease in the patient's sense of smell. Other symptoms may include ear infections, a feeling of ear fullness, or ear popping.

What preparations are made for the procedure?

Usually, just prior to the nasal endoscopy being performed, the physician will spray the nose with both a nasal decongestant to reduce any swelling in the nasal membranes and allow for the endoscope to more easily pass through, and a local anesthetic to numb the area and decrease the chance of sneezing from sensitivity. Patients rarely experience any pain from the procedure. However, if a patient has an unusually small or narrow nasal cavity, or if the nasal membranes are severely swollen, an additional numbing spray may be used for discomfort.

What does the nasal endoscopy procedure entail?

This medical procedure is usually performed in the doctor's clinic. The patient will be seated, and the physician will insert the endoscope into the patient's nose. The endoscope will be attached to a CRT monitor, providing live video, and the patient will remain awake and even be able to follow the procedure. The doctor is able to explain the findings as the exam is performed. The physician will be looking for signs of swelling in the mucous membranes, the presence of drainage from the sinus openings, or deviation of the nasal septum. He / she will also search for the presence of nasal polyps, nasal bleeding, or the presence of tumors within the nasal and sinus cavities. If infection is suspected, a sample may be taken to determine the cause of the infection. In the case that polyps or other masses are found, they may be removed at this time. The endoscope will be withdrawn and in most cases the patient will be allowed to return home the same day. The patient will be advised not to eat or drink for a few hours after the procedure.

What complications may arise?

While nasal endoscopy is generally a low-risk procedure for most people, all surgery carries some risk. Patients with bleeding disorders or those who take blood thinning medication such as aspirin or other anticoagulants should be sure to tell their physician, so that precautions may be taken. In some cases, the surgery may be inappropriate for those patients highly susceptible to nosebleeds. Other potential risks include adverse reactions to the anesthesia, or infection. In patients with heart disease, light-headedness or feeling faint may occur. Other common side effects include sore throat or discomfort in the period following the procedure.

As with any medical procedure, be sure to consult with your doctor about the necessity of the procedure, and whether the potential benefit outweighs the risk in your particular case. Discuss any medical conditions, medications, or other circumstances that may be relevant. Be sure you understand the possible side effects and what to do should a side effect or other unforeseen circumstance arise.

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Properly caring for your endoscopic equipment is a key factor in reducing the risk of cross-contamination leading to infection due to microbial growth. A single scope can be used hundreds or even thousands of times each year. Your patients’ health and safety rely on your use of correct techniques to clean, disinfect, and sterilize your endoscopic equipment.

Appropriate cleaning can reduce up to 95% of all organic debris and micro-organisms present on the endoscopes. Failure to remove organic matter, such as proteins, carbohydrates, fats, chemical salts, and other substances found in blood or mucous, could prevent the disinfectant from being able to function correctly, or even cause the instrument channels in the endoscope to become blocked and not function correctly.

It is essential that guidelines for thoroughly and correctly cleaning and disinfecting the endoscope are strictly adhered to. The process must be performed after every use. Familiarize yourself with and be sure to follow manufacturer and regulatory guidelines for your area when using and cleaning any endoscopy equipment.

Step 1:

Immediately upon finishing the procedure and removing the endoscope from the patient, it should be wiped down. You’ll use a cloth or sponge treated with a special cleansing detergent, which needs to be sterilized or disposed of after use.

Step 2:

Bring the endoscope to the specified cleaning area, Flush it with cleaning solution until it is clear, and suction the endoscope with air, as determined by the manufacturer’s instructions. Enclose the endoscope inside a container and move it to the area specified for disinfection and sterilization – a room that is completely separate from the area the procedure is performed is required in order to minimize the risk of infection.

Step 3:

Manual cleaning is the next step in the process. Prepare a fresh solution of water and medical-grade, neutral pH detergent that is low-foaming and formulated for endoscopes and fill the basin, following the manufacturer’s instructions for dilution and use. Fully submerge the endoscope in the solution, then brush all channels with a small, soft brush and non-abrasive and lint-free cleaning tools. Rinse and repeat until all visible debris has been removed. Some soaking may be required. Rinse thoroughly and use forced air to remove all water from the endoscope. Finish by drying with a soft, lint-free cloth.

Step 4:

Disinfection and sterilization is used to kill any microbes that are still present on the equipment. Follow the manufacturer’s instructions in the use of these products, and test regularly for effectiveness. An automated re-processor can be used for this step, or the operation can be performed manually.
If disinfecting manually, submerge the endoscope and all removable parts in the cleaning solution. Flush this solution through all channels, with no air pockets remaining. Allow the endoscope to remain in the solution for the appropriate time.
Air should be used to purge all channels before removing the endoscope, followed by rinsing, drying, and flushing with alcohol.
In the case of automated disinfection, manually clean the endoscope prior to placing it in the machine. Follow the manufacturer’s instructions to complete the full cleaning cycle from start to finish, without interruptions. If the process is interrupted, it will be necessary to start over. Small channels in some endoscopy tools may need to be reprocessed by hand if the machine cannot do so. Finally, apply a 70% isopropyl alcohol rinse cycle. This may need to be performed by hand. Carefully dry the equipment and store it appropriately to protect against contamination.

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Wireless Capsule Endoscopy (WCE) is a useful tool for visualizing the GI tract, and for the purpose of diagnosing conditions within the small intestine, such as Crohn's Disease, peptic ulcers, cancer, celiac disease, gastro esophageal reflux disease, and unexplained bleeding, for example.

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Understanding the purpose, associated risks, and general expectations before any type of surgery is something everyone should take time to research.You should follow the specific instructions your doctor will give you before your endoscopic procedure. The following is a general explanation and some tips to help you better understand the procedure and feel prepared before the procedure is performed.

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M.D. Endoscopy

As the industry leader of pre-owned, refurbished and used endoscopy equipment, M.D. Endoscopy, Inc. offers one of the largest inventories of endoscopes in the world. We offer products from all major manufacturers including but not limited to Olympus, Pentax and Fujinon with the only and most comprehensive 24-month warranty in the industry.

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