Examination of the nose is rarely limited to what the doctor can see during an external examination. The main changes are located inside the nasal cavity: on the mucous membrane, nasal turbinates, septum, nasal passages, and deeper structures such as the nasopharynx. To assess these structures, an otorhinolaryngologist performs rhinoscopy.

The technique depends on the purpose of the examination. A light source and a nasal speculum are sufficient to examine the anterior sections. When hard-to-reach areas need to be visualized, the doctor uses an endoscope. The optical system transmits an image from the nasal cavity to a camera and monitor, allowing the doctor to view the examined area in an enlarged format. For a diagnostic office, the difference between these methods is significant: endoscopic equipment expands the field of view and makes it possible to document the examination results.

What Is Rhinoscopy?

Rhinoscopy is an examination of the nasal cavity performed by a doctor using a specialized instrument and a light source. The procedure is part of standard ENT diagnostics and may be performed during an initial patient visit, before treatment, or prior to surgery.

During a conventional examination, the doctor uses a nasal speculum. It gently widens the nostril, allowing the specialist to assess the accessible part of the nasal passage. The field of view includes the mucous membrane, nasal septum, inferior nasal turbinate, and other structures of the anterior sections. This method has a natural limitation: the depth of examination depends on the patient's anatomy and the capabilities of the instrument. If the pathological process is located farther inside, the doctor chooses another diagnostic method.

During endoscopic rhinoscopy, a thin endoscope is inserted into the nasal passage. Its optical system generates an image that is transmitted to a video camera and displayed on a monitor. This allows the doctor to examine areas that remain outside the field of view during conventional examination.

When Is Rhinoscopy Recommended?

The procedure is indicated when a patient has relevant symptoms or when it is necessary to assess the condition of the nasal cavity before treatment. Rhinoscopy may also be performed when nasal diseases or structural abnormalities are suspected, including:

• rhinitis and inflammatory diseases of the mucous membrane;
• deviated nasal septum;
• polypoid changes;
• foreign bodies;
• traumatic injuries;
• neoplasms;
• changes in the nasal turbinates.

Rhinoscopy is also used before surgical treatment. The examination findings help the doctor assess the patient's anatomical features and determine whether additional diagnostic methods are required.

The procedure is also performed in children to examine the nasal passages, although the examination technique is selected according to the child's age and behavior.

What Types of Rhinoscopy Are There?

Rhinoscopy can be performed in different ways depending on which part of the nasal cavity needs to be examined. In classical ENT practice, anterior, middle, and posterior rhinoscopy are distinguished.

Anterior rhinoscopy is suitable for an initial examination. The doctor can see the entrance to the nasal cavity, the septum, the inferior nasal turbinate, and the anterior parts of the nasal passages. A nasal speculum is used for this examination. If image magnification is required to examine the tissues in greater detail, the doctor switches to endoscopic optics.

Middle rhinoscopy makes it possible to assess the middle nasal passage and adjacent structures. This area is important when diagnosing inflammatory processes and diseases of the paranasal sinuses. Angled optics are convenient for examining this region because it is located deeper inside the nasal cavity and does not always fall within the field of direct view.

Posterior rhinoscopy is aimed at examining the posterior parts of the nasal cavity and the nasopharynx. Classical examination is performed using a nasopharyngeal mirror. During an endoscopic examination, the doctor obtains an image of the deeper structures on a monitor and can examine them sequentially without using the mirror technique.

For endoscopic rhinoscopy, ElePS manufactures rigid rhinoscopes with diameters of 2.7 and 4 mm. The product range includes models with viewing angles of 0°, 30°, and 70°. A 0° rhinoscope provides a straight viewing direction and is selected for examination along the insertion axis of the instrument. 30° optics provide access to lateral areas and greater flexibility when examining the nasal passages. A 70° rhinoscope is used to examine areas located to the side of the rhinoscope's longitudinal axis.

For ENT office equipment, ElePS manufactures rhinoscopes both as standalone optical instruments and as equipment designed to operate as part of an endoscopic system. The equipment includes adapters for light-guide cables from KARL STORZ, WOLF, and OLYMPUS, allowing it to be integrated with equipment already installed in a clinic. The company's product range also includes equipment for performing rhinoscopy combined with surgical procedures, such as a rhinoshaver with replaceable cutting attachments and burrs developed in-house.

How Is Rhinoscopy Performed?

The procedure depends on the method selected. Before the examination, the doctor asks the patient about their symptoms and examines the nose. If necessary, the nasal passages are cleared of secretions. In some cases, a topical vasoconstrictor is used to reduce mucosal swelling or a local anesthetic is applied. The doctor determines whether such preparation is necessary.

During anterior rhinoscopy, the patient remains seated. The doctor directs a light source into the nasal cavity and carefully widens the nasal passage using a nasal speculum. The visible structures are then assessed sequentially.

An endoscopic procedure is performed somewhat differently. A small-diameter rigid or flexible endoscope is inserted through the nasal passage. An optical system is located at its distal end and transmits the image to a video camera. The image is displayed on a monitor, allowing the doctor to examine the mucous membrane, nasal passages, and deeper structures in detail.

During the examination, it is important for the patient to keep their head still and follow the doctor's instructions. The procedure is generally well tolerated. Patients with increased mucosal sensitivity may experience a sensation of pressure or brief discomfort.

What Does Rhinoscopy Show?

Rhinoscopy allows the doctor to directly assess the condition of the nasal cavity. During an anterior examination, the mucous membrane, septum, nasal turbinates, and anterior parts of the nasal passages can be visualized. Endoscopic examination expands the field of view and makes it possible to examine deeper structures.

What rhinoscopy shows in a particular case depends on the examination method and the optics selected. During the procedure, the doctor can identify:

• the condition of the mucous membrane, including swelling, redness, dryness, crusting, and other changes;
• the nasal septum, including the degree of deviation, areas of deformity, and contact with the nasal turbinates;
• the inferior and middle nasal turbinates, including their size, mucosal condition, and changes affecting nasal passage patency;
• the nasal passages, including narrowing, pathological discharge, and signs of inflammation;
• polyps and other formations protruding into the nasal cavity;
• the source of nasal bleeding, if it is accessible for visual examination;
• foreign bodies, which is particularly relevant when examining children;
• the posterior parts of the nasal cavity and the nasopharynx when appropriate endoscopic optics are used.

During endoscopic rhinoscopy, the doctor can examine an area under magnification and obtain a more detailed view of the condition of the tissues. The camera transmits the image to a monitor, where small anatomical structures and changes in the mucous membrane can be clearly seen. When the appropriate equipment is available, examination results can be recorded as photographs or video.

However, rhinoscopy does not replace other diagnostic methods in all clinical situations. If it is necessary to assess the paranasal sinuses, bone structures, or the extent of a pathological process, the doctor may prescribe additional examinations.

Contraindications and Possible Complications

Rhinoscopy is a diagnostic procedure with a low risk of complications. Absolute contraindications are rare; however, the doctor takes into account the patient's condition, the severity of swelling and inflammation, the tendency to bleeding, the anatomical features of the nasal cavity, and tolerance to topical medications. If the mucous membrane is particularly painful or sensitive, the examination is performed with extra caution. Local anesthesia may be used when necessary.

After the procedure, some patients may experience brief discomfort, sneezing, or minor nosebleeding. These effects usually resolve quickly. When endoscopic equipment is used, proper processing and sterilization of medical instruments are essential.

ElePS develops and manufactures medical equipment on a full-cycle basis. The company uses its own engineering solutions, controls the manufacturing process, and complies with the requirements of the ISO 13485 international quality standard. For a medical facility, this means access to equipment with clear technical specifications and manufacturer service support.