Method of examining
A suggested method of examining nasopharynx with ENTviewer.
Every time you pick up a new device you need to practice and gain some experience in using it. Please read the tips to help you optimise the use of the device. An examination carried out with ENTviewer is nothing else but a nasopharynx assessment from the inside of the mouth, i.e. posterior rhinoscopy.
You should place a foil cover on the spatula and heat it up to prevent the optical elements from fogging.
Place the spatula on the tongue, directing the optical elements upwards. The central part should lean on the incisors. Place it further behind the palate. You should try not to touch the soft palate or uvula. Delicately move the end of the spatula behind the uvula, pressing on the root of the tongue, if necessary. To gain the best insight into the nasopharynx, it is good to ask the patient to inhale through the nose, if possible. Also, tilting the head back at the angle of 20-30 ͦ facilitates getting a better picture.
During the assessment you should not look at the screen, but rather focus on placing the spatula in the right position in order not to irritate the mesopharynx and cause pharyngeal reflex.
The insight may take up a really short time, as the entire examination is recorded on the computer. The device records 15 frames per 0.5 second, and only one good image is needed for the final assessment. The attached software enables viewing individual frames and selecting the best one. Recorded videos and images may be copied, attached to documents, and printed out.
Some difficulties in obtaining the right insight may be expected in the case of a very significant palatine tonsil hypertrophy, where tonsils touch one another at the midline, or in the case of a nasopharynx filled with mucous content. If hypertrophy is very significant, you may try to part the enlarged tonsils, or move the spatula underneath them. If the patient has mucous content in the nasopharynx, a relevant treatment should be applied and the examination carried out on the next visit. In the case of strong pharyngeal reflex, you may consider applying a 10% lignocaine anaesthesia in spray or chewable tablets containing lignocaine derivatives (Envil, Orofar Max, etc.) 10-15 minutes before the examination.
I hope that my tips will make your work with ENTviewer easier. I am happy to help you in case of any questions.
dr n. med. Jarosław Sova
Konsultant Medyczny Sinutronic sp. z o.o.
tel. 530 277 517