Sinuscopy is the method of Endoscopic sinus observation or surgery using Nose telescope. It involves the evaluation of nasal and sinus passages using the endoscope called Sinuscope.The Sinuscope has a narrow tube with a built in camera, so that the physician can see the internal details of the sinuses. By observing the sinus, it is possible to diagnose the problems and treat properly. Sinuscopy can be performed using local or regional anesthesia and the procedure is usually out patient category. Sinuses are the air cavities of the cranial bones especially near the nose region and fore head. The term Sinus is Latin which means “pocket” or “curve”. Sinuscopy plays an important role in pre operative and post operative management in sinusitis. It is also used in Rhinoplasty or Nasal plastic surgery.
The Nasal sinus observation is called Nasal Endoscopy which uses the optical instrument called Nasal telescope. The Nasal telescope has a slender tube having 2.7 to 4 mm diameter so that it can be easily inserted into the sinus. The nasal telescope can be used for straight view as well as angle view of the sinuses. The angled view nasal telescope is helpful to see the angles and corners of the sinus or nose.
Anatomical features of Human Nose
Human nose is the projected part of the face through which air enters into the respiratory system. The nose has two air passages separated by a cartilaginous nasal septum. The nose is Osseo cartilaginous in structure and composed of bones and cartilages. The external skin of nose is divided into three portions like upper section which is thicker; the thin middle section and a lower thicker section. The lower section of skin has more sebaceous and sweat glands.
Internally the nose is lined with mucous epithelium belonging to the sqamous epithelium which then transitions to become columnar respiratory epithelium , a pseudo stratified ciliated epithelium with Seromucinous glands to maintain nasal moisture and protects against infections. Human nose is highly vascularized and richly supplied with blood through the internal and external carotid arteries. The nasal veins are non valvular and have direct communication with the sinus caverns which makes possible the spreading of infections of the nose.
Sinuses are air cavities present between the Facial bones. Healthy sinuses are filled with air and have the same air pressure as the outside. When the sinuses are infected, mucous secretion increases and the air will be absorbed creating a vacuum inside the sinus. This lowers the air pressure inside the sinus leading to facial pain behind the eyes and ears. Along with this, a pounding sensation also develops in the head, face and jaws. Acute infection in the nasal sinus is characterized by the formation of pus inside the nasal cavities, pain etc. The infected nasal mucus fall posteriorily and show the symptoms of Post nasal drip.
Treatment of Sinusitis is aimed to reduce inflammation and infection so as to drain the mucus accumulated in the nasal cavities, so that the nasal passage becomes clear and sinus pressure increases. Antibiotics and Decongestant drugs are required for Chronic (Prolonged) sinusitis. If decongestants are used for prolonged period, it may cause dryness in the sinus and may worsen the symptoms.
Sinuscopy is usually performed by ENT doctors by observing the features of the nasal sinuses using the Sinuscope. Modern Sinoscope has medical video camera that it can be attached to the computer for easy observation and diagnosis. The images can be used for future reference and monitoring the defects. Sinuscopy is a non invasive technique and the patient can tolerate the observation very well. Before doing Sinuscopy, nasal sprays are applied to the nose. If surgery is required, local or regional anesthesia is used. The surgeon can directly localize the specific infected or defective areas for treatment.
Nasal Endoscopy can be done through Flexible fiber optic Sinuscope or Rigid Sinuscope.The Flexible fiber optic Sinuscope is more advantageous since its tube is flexible and is narrow in diameter. So that it can be manipulated to observe different corners of the sinus using light from the tip of the Sinuscope. The normal tissue appears as opaque while the infected areas appear as translucent with pus or mucous. The normal swellings due to allergic reactions can be easily distinguished from areas of infection or tumor growth by comparing both. Digital flexible Sinuscope offers more advantages in high resolution visualization. Rigid Sinuscope gives images of good quality and is also useful to collect samples for culturing. Rigid Sinuscope has the tube diameter of 2.7 to 4 mm and has tip with different angles from 0 to 70 degree.
Digital Sinuscopes are available in 2.7 mm and 4 mm tube diameter having fiber optics to give high resolution images. The viewing angle range from 0, 30, 45, 70 degree angles. Lighting system includes high intensity Xenon lamp giving excellent image clarity. The fiber optic cable provides high quality images at 10 or more mega pixels. The camera system is the CCD type with integrated electronics for excellent imaging. The Ergonomic head and TV adapter is specially designed to transfer the image to PC to process the image.
Best way to reduce sinusitis is the prevention of allergic reactions, nasal infections like cold, avoiding excess cold, dust etc. Proper hygienic conditions in the face and mouth can also reduce the rate of infections to a certain extent.