Flexible endoscopy of the nose and nasopharynx

Flexible endoscopy of the nose and nasopharynx is a modern diagnostic method that provides a detailed view of nasal structures and the posterior pharyngeal region, areas not accessible with standard examinations. At Dr Prlja Medical in Belgrade, the procedure is performed with expertise and care, with your health and comfort as our top priorities. If you experience breathing difficulties, frequent infections, or suspect a more serious condition, nasal endoscopy is the right way to obtain a clear diagnosis. Book your appointment at our clinic today!

Nasal endoscopy at Dr Prlja Medical: A reliable and quick way to check your health

Our ENT clinic in Belgrade offers a precise, fast, and comfortable examination of the posterior nasal area and the upper pharynx (nasopharynx) using an endoscope, without disturbing the natural position of the structures, including their movements during:

• swallowing
• breathing
• speaking

The examination usually takes only a few minutes and is performed while the patient is awake. This endoscopic examination is simple and quick, even in people with a strong reflex. The feeling of discomfort is minimal. The method provides accurate information because no forced positioning is applied, and the doctor gains insight into the moving structures in their natural state.

When is this examination recommended?

Flexible endoscopy of the nose and nasopharynx is recommended in cases where classical rhinoscopy cannot provide enough information about the posterior parts of the nose and throat.

• It is particularly important in adult patients when there is suspicion of enlarged adenoids, a condition often overlooked during routine examinations. In such cases, third tonsil surgery may be necessary, but timely diagnosis can allow earlier treatment and, in some situations, reduce the need for surgical intervention.
• This examination is also very useful for individuals with frequent ear infections, as it enables a detailed assessment of the Eustachian tube opening and helps identify potential obstructions affecting middle ear ventilation.
• It is advised for patients who have persistent stuffy nose without a cold, as the doctor can precisely determine the cause of the problem and suggest appropriate treatment.
• The examination is also valuable for individuals with breathing difficulties during sleep, especially when loud snoring or sleep apnea is present.
• If there is a suspicion of tumors or nasal polyps in the nose or nasopharynx, this method allows early detection and timely therapy.

Our medical team approaches every patient with care and understanding, ensuring accurate diagnosis and a sense of security throughout the entire process.

What should you know before the examination and how to prepare?

Flexible endoscopy of the nose and nasopharynx usually does not require special preparation. Any specific recommendations are given by the doctor depending on the patient’s health condition. The procedure is safe and generally well tolerated. In patients with a strong gag reflex, a local anesthetic spray may be used to reduce discomfort. The most common reactions may include:

• short-term burning sensation
• watery eyes
• mild bleeding, especially in sensitive mucosa

Serious complications are very rare, but the examination is postponed if there is an acute infection or significant blood clotting disorders.

What does nasal endoscopy look like at Dr Prlja Medical

Flexible endoscopy of the nose and nasopharynx is performed while the patient is seated. Before the examination, a spray is applied into the nasal cavity to reduce mucosal swelling, and if needed, it contains a local anesthetic to increase comfort.

The endoscope, a thin and flexible instrument with a camera and light source, is carefully inserted through one nostril. During the passage, the nasal septum, turbinates, and the posterior part of the nose are visualized. Special attention is given to the nasopharynx, the opening of the Eustachian tube, and the region known as Rosenmüller’s fossa, as these areas are difficult to access with standard examinations.

The examination also includes a dynamic assessment. During the procedure, the doctor observes the movements of the soft palate and the function of the Eustachian tube. That way, they get insight into the function of anatomical structures in real conditions. The image is transmitted to a high-resolution monitor, and photographic documentation or video recording can be made if necessary.

What to expect after the examination

After flexible nasal and nasopharyngeal endoscopy, daily activities can be resumed almost immediately. If a local anesthetic spray was used, it is advised to wait a short time before eating or drinking to avoid discomfort while swallowing. Driving or other usual activities are not restricted, except in rare cases when the doctor recommends a short rest.

Additional examinations and therapies: Your doctor will advise you best

Interpretation of the findings begins immediately after the examination. When the nasal and nasopharyngeal mucosa are normal, a pink color without significant swelling, secretions, or pathological masses is recorded. The opening of the Eustachian tube is free, and during swallowing, its proper opening can be observed.

On the other hand, there are several warning signs that should not be ignored if they appear in the findings after nasal endoscopy.

Chronic changes of the mucosa and inflammatory processes

If chronic changes are observed, such as thickened or pale mucosa, the presence of secretions in the nasopharynx, or limited opening of the Eustachian tube, the doctor may recommend further tests. These can include:

• microbiological swabs to detect bacterial or fungal infections
• allergy testing when allergic rhinitis is suspected
• radiological diagnostics (sinus ultrasound, MRI of the nasopharynx) for a more precise assessment of the affected structures

Tumorous, polypoid, or adenoid masses in adults

A tissue biopsy for histopathological analysis is always advised when the examination reveals:

• adenoid growths in adults
• polypoid masses
• suspicious tumor changes

Depending on the results, the patient is referred to an ENT surgeon, oncologist, or another subspecialist team. In cases of pronounced polyps or structural obstructions of the airways, endoscopic surgical intervention (FESS) is recommended.

Eustachian tube function disorders

In cases of Eustachian tube dysfunction, when signs of secretion retention or swelling that prevents middle ear ventilation are observed, additional tests may be suggested, such as:

• audiometry
• tympanometry
• Eustachian tube ventilation function test
• assessment of outer hair cell function in the cochlea (OAE)

For patients with pronounced symptoms, drug therapy (decongestants, corticosteroid sprays, antihistamines) is often recommended, along with a scheduled follow-up nasal examination to monitor the effectiveness of the prescribed treatment.

Flexible nasal endoscopy helps preserve health

Nasal endoscopy is a reliable and modern method that enables the detection and monitoring of conditions often overlooked during standard examinations. This procedure provides accurate and detailed information about the nasal cavity and nasopharynx. It, therefore, ensures timely diagnosis and an appropriate treatment plan. At Dr Prlja Medical in Belgrade, the examination is performed by an experienced ENT team using modern technology and digital records. Endoscopic exam of the nose at our clinic is the ideal choice for anyone seeking precise diagnostics and safety in therapeutic care. Book your appointment today and improve your health.