Rinoskopiya

Description:

Rinoskopiya (Greek rhis, rhinos a nose + scopeu to consider, investigate) — a nasal cavity research method by means of nasal mirrors (nasal dilators) and a nasopharyngeal mirror.

    Rinoskopiya is made at artificial lighting. At children up to 2 years for a rinoskopiya use ear speculums, children of more advanced age have nasal mirrors of the small sizes.

    Distinguish a front, average and back rinoskopiya. Before R. previously examine a nasal cavity threshold to exclude existence of eczema, a furuncle. At a front rinoskopiya the doctor and the patient sit against each other, to the right of the patient at the level of an ear the light source is located. The head of the patient is fixed, covering a palm of the right hand occipitoparietal area, and the left hand carefully enter a nasal mirror in closed form into a threshold of a nasal cavity of the patient on distance of 3 — 5 — 10 — 20 mm (depending on age). Then gradually, without hurting, move apart branches of a nasal mirror towards nose wings. When carrying out a front rinoskopiya the assistant takes the child on hands from children of younger age, one hand presses his trunk to himself, at the same time fixing both hands of the child, and other hand holds the head in situation, necessary for a research.

    Distinguish two positions of a front rinoskopiya. In the first position (the head of the patient is in direct situation) examine front departments of a bottom of a nasal cavity, its partition, the lower and general nasal courses, the front end of the lower nasal sink. After greasing of a mucous membrane vasoconstrictors and at a wide nasal cavity it is possible to see a back wall of a nasal part of a throat in this position. In the second position (the head of the patient is thrown back back) it is possible to examine the front end of an average nasal sink, average department of a partition of a nose, the average nasal course, a big trellised bubble.

    At an average rinoskopiya position of the doctor and patient same, as well as when carrying out a front rinoskopiya. The average rinoskopiya is made a nasal mirror with the extended branches (50 — 75 mm) which is entered into a nasal cavity in closed form after preliminary anesthesia of a mucous membrane of a nasal cavity and especially average nasal course, sometimes with addition of vasoconstrictors. Then, carefully moving apart mirror shutters, push aside an average nasal sink towards a nose partition then examine the average nasal course, a semi-lunar crevice, openings of the frontal sinus, front and average cells of a sievebone and a maxillary (Highmore's) bosom. At introduction of a nasal mirror between an average nasal sink and a partition of a nose, gradually advancing branches deep into, it is possible to see above all olfactory area,
behind — an apertura sinus sphenoidalis.

    The back rinoskopiya is used for a research of back departments of a nasal cavity. The pallet taken in the left hand otdavlivat language from top to bottom, and the right hand enter the nasopharyngeal mirror which is previously slightly warmed up, up honor with a smooth surface to a back wall of a throat. To avoid emergence of an emetic reflex, investigated suggest to breathe quietly a nose, having widely opened a mouth. At the same time the soft palate considerably relaxes, hangs down from top to bottom and kpered, and a nasopharynx becomes well foreseeable. When the emetic reflex is raised, before carrying out a back rinoskopiya the mucous membrane of a back wall of a throat and a nasopharynx is irrigated or greased with the anesthetizing solutions. For carrying out a back rinoskopiya also the fiberscope or a special tip and the lighter entering a set of otorhinolaryngological mirrors with a fiber optics use.

    At a back rinoskopiya it is possible to examine a vault of the farynx, a share, a postnaris, the back ends of nasal sinks, mouths of acoustical pipes, pharyngeal pockets, a back surface of a soft palate.