Surgeon carrying out rigid nasal sinus endoscopy and suction treatment
Nasal polyp seen through an endoscope in the right side of the nose. Key:mt = middle turbinate it = inferior turbinate s = nasal septum p = polyp
Rigid Nasal Sinus Endoscopy (RNE, FESS telescope)

Information on rigid nasal endoscopy updated 16 August 2014

The rigid nasal endoscope is a small instrument, like a silver pencil with a light on the end, 4 millimetres or less in diameter and around 20cm long. With a range of angled lenses to see around corners, and a powerful fibreoptic light source, the surgeon gets detailed close-up views of the internal nose and sinuses. We can also check the back of the nose, and the openings of the Eustachian Tubes which connect with the middle ear. The endoscopic examination looks into all the nooks and crannies of the nose, showing the exact location of any narrowings, bony deformities, polyps and the source of any pus drainage. This helps us make a plan for treatment.

This out-patient examination procedure involves placing a small camera in the nose. It is done

  • to diagnose conditions of the nose, sinuses and nasopharynx accurately, using
    • Storz Hopkins rod telescope for magnified view of narrow openings
    • angled lenses to see around corners
    • high power magnification
    • very bright illumination
  • to cary out minor treatments such as
    • removal of blood clots & crusts following nasal surgery
    • sucking out pus from infected sinuses
    • cautery for nosebleeds

Having rigid nasal sinus endoscopy: What to expect

Before the procedurelocal anaesthetic spray applied to nose before flexible fibreoptic nasolaryngoscopy

  • you will normally receive a local anaesthetic spray immediately beforehand
  • the local anaesthetic will taste bitter and you may imagine your throat is swelling up. Don’t panic, that is just the local anaesthetic working

During the procedure

  • the instrument will be passed gently through your nose, you will be told exactly what to do during the procedure
  • lie still and breathe through the mouth
  • remember your nose is 4 to 5 inches long

After the procedure

  • don’t get up until the nurse says so – you may be dizzy
  • we will normally tell you the result of the examination straight away
  • you should not eat or drink till the local anaesthetic has worn off – about an hour
  • you should be ok to drive after an hour

What other options are there?

If we only want to look, we can use a flexible nasolaryngoscope instead. But the rigid endoscope is better if we want to do something in the nose, because the surgeon only needs one hand to hold the rigid nasendoscope, and the other hand is then free to carry out therapeutic procedures such as suction of secretions or cauterisation for nosebleeds.

Without any kind of endoscope, we can see only just inside the front inch (2-3cm) of the nose, by stretching the nostrils a little and shining a light. We can sometimes get a view of the back of the nose using a mirror held in the mouth, and that was the standard method before nasal endoscopes were in widespread use. Because the nose is 4-5 inches 10-12cm long, the view into the middle part of the nose – where the sinuses open into – is not very good, so without using some kind of endoscope, the examination is incomplete.