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Flexible nasopharyngoscopy (also called fiberoptic nasendoscopy/flexible nasolaryngoscopy/flexible fiberoptic nasopharyngolaryngoscopy) is an essential skill for any otorhinolaryngologist (ENT surgeon). It is a diagnostic procedure used for examination of the nose, throat, and airway. This activity describes the indications, contraindications and complications of flexible nasopharyngoscopy and highlights the role of the interprofessional team in assessing and managing patients with upper airway disorders. Objectives: Review the technique of flexible nasopharyngoscopy Outline the indications for flexible nasopharyngoscopy Summarize the complications of flexible nasopharyngoscopy Describe how an interprofessional team approach can improve outcomes in patients undergoing flexible nasopharyngoscopy Access free multiple choice questions on this topic.
Flexible nasopharyngoscopy (also called fiberoptic nasendoscopy/flexible nasolaryngoscopy/flexible fiberoptic nasopharyngolaryngoscopy) is an essential skill for any otorhinolaryngologist (ENT surgeon). It is a diagnostic procedure used for examination of the nose, throat, and airway. Fiberoptic imaging became prominent in the 1950s due to the innovations of Hopkins and Stortz. The first medically functioning fiberoptic scope was designed in 1963 by Hirschowitz.[1]
The following represent some of the possible comlications[10][11][12]: Although complications are rare, the most common are sneezing, and mucosal tearing and bleeding secondary to injury - to prevent this, adequate nasal decongestion and limited force should be used Laryngospasm, a serious risk, although reported in less than 1% of procedures Gagging and adverse reaction to the nasal decongestant are other potential risks Damage to anatomic structures is more common with the use of rigid scopes, and rarely seen with flexible scopes
Interpretation and ability to carry out flexible nasopharyngoscopies remains a skill and a learning curve. Although the ENT surgeon does these procedures daily, and so their learning curve is much faster, other related specialists, including anesthesiologists, nurse anesthetists, and the pulmonologists, can use this tool and quickly pick up the expertise also. New gadgets used in stroboscopy, digital chip-on-the-tip technology, and endoscopic smartphone adapters keep the technology moving forward.[13][14][15]