Endoscopy, Sinus

Endoscopy, Sinus

Synonym/acronym: N/A.

Common use

To facilitate diagnosis and treatment of recurring sinus infections or infections resulting from unresolved sinus infection, including incursion into the brain, eye orbit, or eyeball.

Area of application

Sinuses.

Contrast

N/A.

Description

Sinus endoscopy, done with a narrow flexible tube, is used to help diagnose damage to the sinuses, nose, and throat. The tube contains an optical device with a magnifying lens with a bright light; the tube is inserted through the nose and threaded through the sinuses to the throat. A camera, monitor, or other viewing device is connected to the endoscope to record areas being examined. Sinus endoscopy helps to diagnose structural defects (e.g., polyps or other abnormal growths), damage, and acute or recurring infection to the nose, sinuses, and throat. The procedure is usually done in a health-care provider’s (HCP’s) office, but if done as a surgical procedure, the endoscope may be used to remove polyps from the nose or throat.

This procedure is contraindicated for

    N/A

Indications

  • Nasal obstruction
  • Recurrent sinusitis

Potential diagnosis

Normal findings

  • Normal soft tissue appearance

Abnormal findings related to

  • Foreign bodies in the nose
  • Growths in the nasal passages
  • Polyps
  • Sinusitis

Critical findings

    N/A

Interfering factors

  • Inability of the patient to cooperate or remain still during the test because of age, significant pain, or mental status may interfere with the test results.

Nursing Implications and Procedure

Pretest

  • Positively identify the patient using at least two unique identifiers before providing care, treatment, or services.
  • Patient Teaching: Inform the patient this procedure can assist in locating and treating infection of the sinus or surrounding areas.
  • Obtain a history of the patient’s complaints or clinical symptoms, including a list of known allergens, especially allergies or sensitivities to latex, anesthetics, or sedatives.
  • Obtain a history of the patient’s respiratory system, symptoms, and results of previously performed laboratory tests and diagnostic and surgical procedures.
  • Obtain a list of the patient’s current medications, including herbs, nutritional supplements, and nutraceuticals (see Effects of Natural Products on Laboratory Values online at DavisPlus).
  • Instruct the patient to remove contact lenses or glasses, as appropriate.
  • Review the procedure with the patient. Inform the patient that the procedure is usually done with the patient awake and seated upright in a chair. Address concerns about pain and explain that a local anesthetic spray or liquid may be applied to the throat to ease with insertion of the endoscope. Inform the patient that the procedure is usually performed in the office of an HCP and takes about 10 minutes.
  • Sensitivity to social and cultural issues, as well as concern for modesty, is important in providing psychological support before, during, and after the procedure.
  • Note that there are no food, fluid, or medication restrictions unless by medical direction.
  • Make sure a written and informed consent has been signed prior to the procedure and before administering any medications.

Intratest

  • Potential complications:

  • Bleeding; cerebrospinal fluid leakage from the ethmoid sinus

  • Instruct the patient to cooperate fully and to follow directions. Instruct the patient to remain still throughout the procedure because movement produces unreliable results.
  • Avoid the use of equipment containing latex if the patient has a history of allergic reaction to latex.
  • Seat the patient comfortably. Instill ordered topical anesthetic in the throat, as ordered, and allow time for it to work.
  • Observe that the endoscope is inserted and the structures inside the nose are examined.
  • Observe standard precautions, and follow the general guidelines in Patient Preparation and Specimen Collection. Positively identify the patient, and label the appropriate specimen container with the corresponding patient demographics, initials of the person collecting the specimen, date, and time of collection, if cultures are to be obtained on aspirated sinus material.

Post-Test

  • Inform the patient that a report of the results will be made available to the requesting HCP, who will discuss the results with the patient.
  • Instruct the patient to wait until the numbness in the throat wears off before attempting to eat or drink following the procedure.
  • Recognize anxiety related to test results. Discuss the implications of abnormal test results on the patient’s lifestyle. Provide teaching and information regarding the clinical implications of the test results, as appropriate.
  • Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP. Answer any questions or address any concerns voiced by the patient or family.
  • Depending on the results of this procedure, additional testing may be needed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. Evaluate test results in relation to the patient’s symptoms and other tests performed.

Related Monographs

  • Related tests include CT brain.
  • Refer to the Respiratory System table at the end of the book for related tests by body system.