Systematic Diagnostic Nasal Endoscopy

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Systematic Diagnostic Nasal Endoscopy
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• Reda Kamel
• Professor of Rhinology
• Cairo University
• Egypt

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Diagnostic Endoscopy

• Equipment
• Procedure
• Normal endoscopic findings
• Anatomical variations
• Pathological abnormalities
• Limitations
• Reda Kamel

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Diagnostic Endoscopy Advantages

• Illumination
• Depth of focus
• Angled vision

• Accurate early diagnosis
• Documentation
• Education

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Diagnostic Endoscopy

• Indications
• Procedure
• Findings
• Special techniques
• Limitations

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Diagnostic Endoscopy

• Indications
• Procedure
• Findings
• Special techniques
• Limitations

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Diagnostic Endoscopy Indications

• Persistent nasal symptoms
• Obstruction
• Discharge
• Headache
• Epistaxis
• Snoring

• Special techniques
• Biopsy
• CSF Leak
• Follow-up
• Culture

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Diagnostic Endoscopy

• Indications
• Procedure
• Findings
• Special techniques
• Limitations

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Diagnostic Endoscopy Procedure

• Equipments
• Position
• Anesthesia
• Vasoconstrictor
• Blow the nose
• Steps three paths

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Diagnostic Endoscopy Procedure

• Equipments
• Position
• Anesthesia
• Vasoconstrictor
• Blow the nose
• Steps three paths

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Diagnostic Endoscopy Equipments

• Light source
• Cable
• Endoscope 0 - 30 degree , wide angle , 2.7 -
  4 mm
• Suction tubes straight - curved
• Forceps forward - upward

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Diagnostic Endoscopy Procedure

• Equipments
• Position
• Anesthesia
• Vasoconstrictor
• Blow the nose
• Steps three paths

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Diagnostic Endoscopy Position
Endoscopist
Patient
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Diagnostic Endoscopy Procedure

• Equipments
• Position
• Anesthesia
• Vasoconstrictor
• Blow the nose
• Steps three paths

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Diagnostic Endoscopy Procedure

• Equipments
• Position
• Anesthesia
• Vasoconstrictor
• Blow the nose
• Steps three paths

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Diagnostic Endoscopy

• Indications
• Procedure
• Findings
• Special techniques
• Limitations

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Diagnostic Endoscopy Findings

• Findings Important area six
• Common endoscopic findings
• Possible anatomical variations
• Possible pathological abnormalities

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Areas of Surgical Importance Six

• Diagnostic Endoscopy
• Overall view
• Inferior turbinate meatus
• Choana Nasopharynx
• Ostiomeatal complex OMC
• Superior MeatusSphenoethmoidal Recess
• Skull Base

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1- Overall view

• Mucosa
• Secretions
• Cavity
• Septum

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1- Overall view

• Mucosa
• Swollen
• Papillary
• Atrophic

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1- Overall view

• Secretions
• Watery bubbles
• Mucoid
• Purulent
• Mucin
• Blood crusts

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Equipment

• Light source
• Cable
• Endoscope 0-30 degree
• Suction tip
• Forceps forward - upward
• Reda Kamel

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Diagnostic Endoscopy

• Equipment
• Procedure
• Normal endoscopic findings
• Anatomical variations
• Pathological abnormalities
• Limitations
• Reda Kamel

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Diagnostic Endoscopy Procedure
Reda kamel
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Diagnostic Endoscopy

• Equipment
• Procedure
• Normal endoscopic findings
• Anatomical variations
• Pathological abnormalities
• Limitations
• Reda Kamel

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Diagnostic Endoscopy Procedure
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Reda kamel
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Nasopharynx
Roof
Posterior wall
Eustachian tube
Eustachian tube
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Reda kamel
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Middle turbinate
Septum
Inferior turbinate
Floor
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Reda kamel
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Diagnostic Endoscopy Procedure
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Reda kamel
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Middle turbinate
Agger cells
Uncinate process
Inferior turbinate
Bulla ethmoidalis
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Reda kamel
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Frontal ostium
Maxillary ostium
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Reda kamel
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Diagnostic Endoscopy Procedure
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Reda kamel
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Superior turbinate
Sphenoid sinus
Sphenoid ostium
Posterior ethmoids
Septum
Middle turbinate
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Reda kamel
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Diagnostic Endoscopy

• Equipment
• Procedure
• Normal endoscopic findings
• Anatomical variations
• Pathological abnormalities
• Limitations
• Reda Kamel

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Anatomical variations
Concha bullosa
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Reda kamel
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Diagnostic Endoscopy

• Equipment
• Procedure
• Normal endoscopic findings
• Anatomical variations
• Pathological abnormalities
• Limitations
• Reda Kamel

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Pathological abnormalities
polyp
Reda kamel
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Diagnostic Endoscopy

• Indications
• Procedure
• Findings
• Special techniques
• Limitations

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Diagnostic Endoscopy

• Special techniques
• Biopsy
• CSF Leak
• Follow-up
• Culture

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Diagnostic Endoscopy 1- Biopsy

• Nose
• Nasopharynx
• Fungal sinusitis
• Granuloma
• Tumor
• Benign
• Malignant

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Diagnostic Endoscopy 3-Follow up

• Post-operative
• Post-irradiation
• Post-pharmacotherapy
• Post-immunotherapy

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Diagnostic Endoscopy

• Equipment
• Procedure
• Normal endoscopic findings
• Anatomical variations
• Pathological abnormalities
• Limitations
• Reda Kamel

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Limitations

• Difficulties
• Deviated septum
• Anatomical variations
• Inaccessible areas
• Paranasal sinuses
• Lateral sinus
• Reda Kamel

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