What is a Fiberoptic Nasopharyngoscopy?

Fiberoptic nasopharyngoscopy is a procedure used to examine various body structures from the nasal cavity down to the vocal cords. These structures include nasal septum, frontal and sphenoid sinuses, the posterior uvula, base of tongue, and epiglottis. Prior to the development of fiberoptic technology for medical procedures in the 1950's and 60's, surgeons would have relied more the traditional laryngoscopy with hand held mirror or angled telescope to examine a patient's larynx and adjacent structures. The smaller and more portable fiberoptic nasopharyngoscopy allows a surgeon to see the nasopharyngeal anatomy with better clarity and precision.

What is fiberoptic nasopharyngoscopy used to diagnose?

Fiberoptic nasopharyngoscopy can be used to diagnose a number of diseases and conditions. Within the nasal cavity, surgeons can use fiberoptic nasopharyngoscopy to observe polyps, tumors, and sources of epistaxis or nosebleeds. Within the nasopharynx and oropharynx, surgeons can not only see tumors and polyps, but also diagnose obstructive sleep apnea, dysphagia, change in tone of voice, and visualize any foreign bodies that may be obstructing a patient's airway.

What are the benefits of using fiberoptic nasopharyngoscopy instead of the traditional laryngoscopy?

Patient comfort and safety are two good reasons to use fiberoptic nasopharyngoscopy instead of the traditional laryngoscopy. Fiberoptic nasopharyngoscopy is done under conscious sedation using a small tube inserted into the patient's nasal cavity than can have a distal diameter as small as 2mm. Additionally, this procedure rarely causes injury to the patient. The most common problem that could develop is tearing of the mucosal lining that could lead to epistaxis, and even this could potentially be avoided if the procedure is performed by a skilled surgeon using a smaller diameter scope.

When should a fiberoptic nasopharyngoscopy not be used?

Patients with epiglottitis (inflammation of the epiglottis) should not have this procedure done unless it is performed by a highly skilled surgeon. Although epiglottitis is rare, it can cause swelling and possible blockage of the patient's airway leading to a medical emergency. Also, patients on anticoagulant medications could be at risk for severe bleeding from even minor trauma.

note: this article is for informational purposes only. Anyone experiencing signs or symptoms such as shortness of breath, hoarseness, change of voice, dry cough should see their physician before diagnosing themselves.

Sources:

eMedicine, Fiberoptic Nasopharyngoscopy, updated April 2009