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Nasal endoscopy is usually performed by an ENT physician (ear-nose-throat physician or otorhinolaryngologist) in the office. There are no special precautions that are required to prepare for the nasal endoscopy but any steps or restrictions that a physician may deem necessary should be followed closely.    

If a physician recommends a sedative for the nasal endoscopy, it is likely the patient will be incapable of driving home after the procedure. If a sedative is to be used, patients should arrange in advance for someone to drive them home.

Once at the office, the patient will dress in a hospital gown and lie down on an examination table. Usually, the ENT or another healthcare professional will spray a topical decongestant, such as a nasal vasoconstrictor, and topical anesthetic (numbing medicine) inside the nose prior to the procedure. The medication has an unpleasant taste and may cause numbness in the teeth and/or throat for 20 to 30 minutes. Patients may also have a temporary sensation of not being able to swallow.

The procedure begins with the careful insertion of a sterile endoscope into a patient’s nostril. In some people, this may stimulate an uncomfortable gag reflex or irritate the lining of the nose sufficiently to cause a nosebleed or coughing. As the endoscope is guided through the nasal passageways, the physician examines the interior of the nose and nasal cavity for any signs that may indicate a problem (e.g., polyps, infections, fungal concretions). While the endoscope is too large to be inserted into the actual sinus cavities, it can be used to effectively examine the entrance to the sinus cavities.

The endoscope is often directed toward one area in particular: the hiatus semilunaris (a crescent-shaped groove that serves as a small channel that drains fluids from the sinuses). This area is typically where problems such as pus, fungus or polyps can be found. Sometimes, an endoscopically directed microswab culture or sample is obtained in this area. Taking a tissue sample is usually painless. The physician will then send the tissue sample to a lab for closer examination.

After the procedure, the endoscope is carefully removed from the nasal cavity and nostril. The patient can typically return to most activities. If an anesthetic was used, the patient may have to wait until the effects wear off to be able to drive, eat or drink. A saline irrigation may be recommended to reduce crusting in the nose and sinus cavity and to keep the sinus openings clear.

If the endoscopy identifies any growths, infections, polyps, defects or pus that interfere with the normal draining of the sinuses, further treatment may be required. The physician will contact the patient to explain any additional measures that need to be taken.