What is fibroscopy?
Fibroscopy is an examination performed with a flexible fiber optic instrument connected to a cold light source and usually to a camera and monitor.
It allows easy and direct exploration of body cavities that would otherwise be very difficult or impossible to see.
Uses of the fibroscope in Otorhinolaryngology
In Otorhinolaryngology, fibroscopy is commonly used to explore and diagnose pathologies of the upper aerodigestive tract.
Fibroscopy allows ENT specialists to make more precise and earlier diagnoses in these areas.
Depending on the area explored, the technique has a specific name and enables us to make different diagnoses:
- Exploration of the nasal cavity and nasopharynx (cavum) is called nasofibroscopy and allows diagnosis of conditions such as:
- Acute and chronic sinusitis
- Tumors in the nasal cavities
- Posterior septal deviations
- Turbinate hypertrophy
- Adenoid hypertrophy (adenoids)
- Tumors in the nasopharynx
- Exploration of the oropharynx, including the base of the tongue, is useful in detecting foreign bodies, tumors, or lesions caused by the human papillomavirus (HPV).
- Exploration of the larynx (fibrolaryngoscopy) allows diagnosis of conditions such as:
- Benign and malignant tumors
- Immobility or paralysis of the vocal cords
- Presence of vocal nodules
- Others
- Exploration of the hypopharynx, above the pharyngoesophageal junction, allows evaluation of retained secretions, bulging of the walls in cases of abscess, or the presence of tumors, both benign and malignant.
Other conditions diagnosed with fibroscopy
Currently, one of the main uses of the fibroscope in ENT is the dynamic study of swallowing in patients with dysphagia (difficulty swallowing).
Through this examination and using different textures and volumes, we can assess the risk of food aspiration into the lungs.
Another very common application of fibroscopy in ENT today is performing sleep endoscopy or DISE (Drug-Induced Sleep Endoscopy) in patients with snoring and obstructive sleep apnea. This test allows dynamic evaluation of the upper airway during induced sleep, which is extremely useful for refining the diagnosis and tailoring therapeutic options on an individual basis.
How is fibroscopy performed in the ENT area?
At Altiorem, we have several fibroscopes. If necessary, we ask the patient to sit in the examination chair and breathe calmly through the nose. Then, we insert the fibroscope through one or both nostrils, as appropriate, and advance until reaching the area to be examined.
Exploration with the flexible fibroscope causes slight discomfort due to the friction of the fiber against the nasal and/or pharyngeal mucosa. Most of the time, it is well tolerated (even by children) and can be performed without any type of anesthesia.
Although it may seem otherwise, fibroscopy does not cause a sensation of suffocation and generally does not produce nausea. However, in some cases where the area is more sensitive or the patient has a strong gag reflex, it may be necessary to numb the area slightly with a spray anesthetic.
Other uses of fibroscopy in ENT
Less common applications of fibroscopy in Otorhinolaryngology include the exploration of the subglottic area, trachea, and main bronchi in patients with a tracheostomy cannula.
IMAGES OBTAINED WITH FIBROSCOPY
Fibroscopic image of the left nasal cavity, showing the inferior and middle turbinates and the nasal septum.
Fibroscopic image of the nasopharynx (cavum), showing the choana, adenoids, and the opening of the Eustachian tube.
Fibroscopic image of the larynx, showing the glottic area with the vocal cords, ventricular folds, and arytenoids.