What is rhinoscopy?
Rhinoscopy is a procedure that employs an endoscopic device to examine the nasal cavities, sinuses, and posterior nasopharynx. A thin, 3mm-diameter endoscope is gently inserted into both nostrils and the posterior nasal cavity, capturing high-definition video images in real-time of the nasal mucosa and secretions as it goes. This method aids in diagnosing and treating various upper respiratory tract conditions, including those affecting the nose, sinuses, and nasopharynx.
When would a rhinoscopy be necessary?
Nasal endoscopy is typically recommended for the following situations:
1. Persistent nasal congestion or breathing difficulties.
2. Recurrent sinus infections or chronic sinusitis.
3. Nasal polyps or growths.
4. Allergic rhinitis or sinusitis.
5. Difficulty swallowing or suspected throat problems originating from the nasal cavity.
6. Nosebleeds that do not stop easily or have an unusual origin.
7. Post-operative follow-up after nasal surgery.
8. Unexplained headaches or facial pain.
9. Infections or inflammation of the nasal passages or sinuses.
10. Animal owners with concerns about their pet’s respiratory health, particularly for dogs or cats with snoring or breathing issues.
A healthcare professional will determine the appropriateness of rhinoscopy based on the pet’s symptoms and medical history.
Inspection purpose
1. Diagnosing Conditions
Types of Disorders:
• Inflammatory conditions such as ulcers and edema in the nasal mucosa
• Nasal polyps
• Foreign objects (grains, toys, parasites) present in the nasal cavity
• Nasal tumors
• Chronic nasal inflammation often caused by antibiotic-resistant bacterial infections
• Fungal infections
• Viral infections in the nasal area
2. Managing or Treating Diseases
• Nasal irrigation (flushing)
• Sampling of secretions (cytological tests, antibiotic sensitivity testing, fungal culture, pathogen nucleic acid testing)
• Tumor excision or laser ablation (removal of nasal masses)
• Extraction of foreign objects (removal of foreign substances from the nasal cavity)
Chronic Rhinitis Examination Protocol
1. **Patient preparation**: Explain the procedure to the pet owner, obtain consent, and administer any necessary sedation or anesthesia.
2. **Pre-examination assessment**: Review medical history, previous treatments, and current symptoms.
3. **Equipment setup**: Set up the rhinoscope and ancillary equipment, ensuring sterility.
4. **Anesthesia induction**: Administer anesthesia to ensure comfort and minimize discomfort during the procedure.
5. **Nasal endoscopy**: Insert the rhinoscope into the nostrils, slowly advancing it through the nasal passages to the sinus cavities.
6. **Video recording and imaging**: Capture high-quality video footage and images of the nasal and sinus areas, focusing on any signs of inflammation, swelling, or structural changes.
7. **Sampling (if needed)**: Collect tissue or secretion samples for laboratory analysis (cell counts, cultures, or molecular tests).
8. **Clinical evaluation**: Assess the nasal mucosa, ostia, and any visible abnormalities.
9. **Diagnostic decisions**: Based on the examination findings, make a diagnosis or recommend additional tests if necessary.
10. **Treatment planning**: Discuss treatment options with the owner, such as medications, decongestants, or referral to specialists.
11. **Post-procedure care**: Provide instructions for at-home care, including any necessary rinses or medications.
12. **Follow-up**: Schedule a follow-up appointment to monitor the pet’s response to treatment and evaluate the effectiveness of the procedure.
This protocol ensures a systematic and thorough approach to evaluating and managing chronic rhinitis in pets.
Inspection results and follow-up
1. Nasal endoscopy results and pictures will be available after the examination, but the examination report will take 3 working days to be issued.
2. The results of pathogen nucleic acid detection will be available in about 3-4 hours.
3. Drug susceptibility testing, fungal culture, tissue cases and other inspection items will take 5-7 days.
Precautions for nasal endoscopy
Before inspection
• **Fast for 6 hours prior to the procedure**: No food or water intake.
• **Stop medication**: Discontinue oral antibiotics and topical drops, if applicable, at least 5 days before the rhinoscopy.
• **Manage stress for cats**: Minimize stress exposure for your cat by keeping them calm; consider pre-procedure administration of Feliway or gabapentin for stress relief.
• **Reduce exercise for dogs**: Limit physical activity in dogs before the day of the exam, and avoid long walks or exposing them to hot temperatures on the day of the rhinoscopy.
After inspection
• **Post-anesthesia care**: Wait 4-6 hours after recovery from anesthesia before offering small amounts of food and water.
• **Post-procedure environment**: Maintain room temperature between 24-28°C to minimize sensitivity in the nasal area, avoiding cold drafts. Also, minimize exposure to dust, smoke, perfumes, and plants, as these can irritate the nose.
• **Common post-rhinoscopy reactions**: Expect some temporary symptoms like runny nose, minor nosebleed, or nasal sensitivity within the first 24 hours. These are typically normal and should resolve on their own within this period. If symptoms persist after 24 hours, promptly contact the veterinary hospital for follow-up.
