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Posterior Rhinoscopy: Symptomatology and Methods

It is carried out to examine the post nasal space (nasopharynx). It is a difficult space to examine so the disease may be hidden for quite a long time. Different methods of examining the area are;

  • Post nasal mirror.
  • Nasopharyngoscope.
  • Examination under anaesthesia after palatal retraction.
  • Digital palpation.
  • Radiological examination.

Symptomatology of lesions of the nasopharynx

  • Nasal obstruction Post nasal drip
  • Bleeding. Should be taken seriously as it may be due to a tumor.
  • Pain
  • Aural symptoms of deafness, discharge, and blockage.

Method of Posterior Rhinoscopy

Post Nasal Mirror

t consists of a handle on which a small mirror is attached to shaft at an angle of 110. There is another angulation in the shaft.

Technique

  • Hold the mirror like a pen in the right hand. Warm the mirror slightly on the flame of the spirit lamp to avoid condensation from the expired air.
  • Ask the patient to open the mouth.
  • Take the tongue depressor in the left hand and depress the anterior 2/3rds of the tongue.
  • Feel the warmth of the mirror on the back of the wrist. It should not be hot.
  • Introduce the mirror from the angle of the mouth over the tongue depressor and slide it behind the uvula. Avoid touching the posterior wall of the pharynx as it may trigger gagging.
  • Instruct the patient to breath through the nose.
  • Tilt the mirror in different direction tot see various structures of the nasopharynx.


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