Fibroscopy: What is it? Indications, Types, Fibroscope and Contraindications

It is a procedure that serves as an objective diagnostic tool in the evaluation of nasal mucosa, sinonasal anatomy and nasal pathology.

The specialist evaluates the nasal and sinus passages with direct vision using a fiber, a device with an enlarged view of high quality, generally connected to a camera, that can illuminate and visually explore the interior of said corporal cavities.

Nasal fibroscopy can be performed with a flexible fiber optic fibroscope. When performed by experienced physicians, the flexible fibroscope is usually well tolerated.

Indications

Indications for nasal fibroscopy include, but are not limited to, the following:

  • Initial identification of the disease in patients who experience nasosinusal symptoms (eg, mucopurulent drainage, pain or facial pressure, nasal obstruction or nasal congestion or decreased sense of smell)
  • Evaluation of the response of patients to medical treatment (for example, resolution of polyps , purulent secretions or edema and mucosal inflammation after treatment with topical nasal steroids, antibiotics, oral steroids and antihistamines ).
  • Evaluation of unilateral disease.
  • Evaluation of patients with impending complications of sinusitis .
  • Obtain a culture of purulent secretions.
  • Debridement and removal of scabs, mucus and fibrin from the nasal and nasal cavities obstructed after functional sinus endoscopic surgery.
  • Evaluation of the recurrence of the pathology after endoscopic sinus surgery (this is particularly valuable in the follow-up of intranasal tumor recurrence).
  • Evaluation and biopsy of nasal masses or lesions.
  • Evaluation of the nasopharynx for lymphoid hyperplasia , problems with the eustachian tube and nasal obstruction.
  • Evaluation of cerebrospinal fluid (CSF) leak.
  • Evaluation and treatment of epistaxis. Treatment of epistaxis is also possible by the Dicynone tablet.
  • Evaluation of hyposmia or anosmia.
  • Evaluation and treatment of nasal foreign bodies.

Types

Fibroscopia nasal:

Nasal fibroscopy and imaging are the two objective measures most commonly used in the diagnosis of chronic rhinosinusitis (CRS). Fibroscopy has multiple uses in the treatment of patients with nasosinusal symptoms and plays an important role in the preoperative and postoperative management of patients.

The addition of nasal fibroscopy to the care of patients with chronic rhinosinusitis has resulted in improved diagnostic accuracy.

In combination with established symptom criteria, the endoscopic findings improve the specificity, the positive predictive value and the negative predictive value of the evaluation for chronic rhinosinusitis.

This development suggests that the use of diagnostic fibroscopy can help decrease the need for a computed tomography (CT) scan and reduce costs and exposure to radiation.

In addition to providing an objective measure in the examination, fibroscopy is also considered the standard criteria for tissue sampling and harvesting when properly performed.

In the postoperative period, fibroscopy plays an important role not only in monitoring the recurrence of the pathology but also in allowing timely debridement in the immediate postoperative period.

High digestive fibroscopy:

The upper digestive fibroscopy or esophageal fibroscopy is an examination that allows the study of the internal wall of the upper part of the digestive tract in the form of balance sheets in people with digestive hemorrhage, stomach ulcers, a history of esophageal or stomach tumor, nflammation resistant to treatment , gastric reflux or pain or persistent digestive disorder.

This test examines the inner wall (mucosa) of the esophagus, stomach, and duodenum to detect abnormalities and take samples to study the tissues under a microscope (biopsies).

Fibroscopio

A fibroscope is a flexible fiber optic bundle with an eyepiece on one end and a lens on the other that is used to examine and inspect small, hard-to-reach places such as the interior of machines, locks and the human body.

Applications in medicine:

Fibroscopes are used in the field of medicine as a tool to help doctors and surgeons to examine problems in a patient’s body without having to make large incisions.

Doctors use this when they suspect that a patient’s organ is infected, damaged or cancerous. There are numerous types based on the area of ​​the body being examined.

Contraindications

There are no absolute contraindications for nasal fibroscopy; however, some patient populations have a higher risk of complications.

In patients who have a history of a bleeding disorder or who are receiving anticoagulants, nasal fibroscopy should be done carefully so as not to cause bleeding.

In addition, in an anxious patient or in a patient with cardiovascular disease, there is a risk of a vasovagal episode.