When does a doctor decide to perform a nasal endoscopy for sore throats?

Doctor's Answers 2

A nasal endoscopy is the most important workhorse of my specialty Otolaryngology (Ear Nose Throat). We use it to carefully and thoroughly examine all openings of the ear, nose and throat as many pertinent findings may be missed from a mere glance on the outside.

Most sore throats (pharyngitis) are probably due to viral infections and only need to be further examined with a nasal endoscopy usually if the sore throat doesn’t improve with simple painkillers or antibiotics prescribed by the GP, if the sore throat is getting worse or is affecting the patient’s ability to swallow. Persistent sore throats which tend to be more localised to an area would likely need to be scoped to check for foreign bodies or more sinister conditions like tumours. If the patient has reported swallowing a fishbone which has now led to a sore throat, I would definitely want to check the throat and airway with my nasal endoscope too.

There are many other causes of sore throat that can only be properly evaluated by undergoing a nasal endoscopy such as a constant infected postnasal drip of secretions from your nose due to allergy and sinus problems. Acid reflux causing inflammation of the throat and voicebox is another common cause of a persistent sore throat too and the nasal endoscopy is extremely helpful to help assess this.

In summary, if your sore throat is not getting any better despite simple painkillers and antibiotics, or if it is worsening, or if your sore throat is associated with a hoarse voice, difficulty breathing, noisy breathing, difficulty swallowing, then I would most definitely need to use my trusty nasal endoscope to examine your throat, voicebox and airway. Sometimes, throat infections may progress rapidly to swelling of the airway and difficulty breathing so that a simple sore throat now becomes an emergency life-threatening situation.

If in doubt regarding the cause of your sore throat, consider having a nasal endoscopy, a simple, safe and short procedure easily done in the clinic by an experienced ENT specialist.

A nasal endoscopy (aka nasoendoscopy) is a scope throught the nose and throat region. It allows the assessment of the:

1. Nasal cavity

2. Part of drainage pathway of the sinuses

3. Throat and voicebox region

Usually a nasoendoscopy is recommended when there are:

1. Troublesome or persistent nasal symptoms (e.g. blocked nose, runny nose, sneezing, postnasal drip, loss of sense of smell, nosebleed etc)

2. Troublesome or persistent throat symptoms (e.g. chronic sore throat, hoarse voice, cough, painful swallowing, difficulty swallowing, feeling of something stuck in the throat

3. Ear symptoms which may be related to a problem in the nose or throat region (e.g. fluid behind the eardrum due to an infection in the nose or sinuses or due to a cancer at the back of the nose).

4.Suspicions of cancer in the nose or head & neck region

If your sore throat is associated with some worrisome symptoms e.g. blood-stained phlegm or saliva, has been longer than 1 month, is associated with hoarse voice or difficulty in swallowing, your ENT Specialist is more likely to recommend a nasoendoscopy. If you have risk factors for cancer e.g. heavy smoker or heavy alcohol consumption, again your ENT Specialist will be more likely to recommend a nasoendoscopy.

The procedure itself is often painless and is done under local anaesthesia (nose numbed and decongested with a nose spray). The whole process usually takes less than 3 minutes in my practice and can be tolerated in children as young as 4 years old.

As a nasoendoscopy is considered a Day Surgery procedure with a table code of 1A, it may be insurance claimable (depending on your coverage) or medisave claimable.

Hope this helps and all the best!

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