Otomicroscopy,

Diagnostic nasal endoscopy,

LARYNGOSCOPY

Arnav, Sattwata,
Abhay
Otomicroscopy

• Otomicroscopy refers to the examination of the ear (especially

the external auditory canal and tympanic membrane) under a
microscope.
• It provides binocular vision and magnification, which allows
for a detailed and precise evaluation of the ear structures.
 Features of Otomicroscopy:

• Provides illumination and magnification

(usually 6x to 40x).
• Gives a three-dimensional (3D) view.
• Helps in diagnosis and microsurgical
procedures.
 Uses of Otomicroscopy

Diagnosis of: Surgical applications :

⚬ Chronic suppurative otitis media ⚬ Aural toilet under vision
(CSOM) ⚬ Myringoplasty
⚬ Retraction pockets and
⚬ Tympanoplasty
cholesteatoma
⚬ Mastoid surgeries
⚬ Perforation in tympanic membrane
⚬ Stapedectomy
⚬ Otomycosis, foreign body in ear
canal, etc.
Advantages over ordinary otoscopy

• Better visualization of fine details

• Improved precision in surgery
• Allows for both hands to be free during
procedures (via microscope stand)
Diagnostic Nasal Endoscopy (DNE)

Diagnostic nasal endoscopy is a minimally

invasive procedure used to examine the nasal
cavity, turbinates, meatuses, nasal septum,
and nasopharynx using a rigid or flexible
nasal endoscope.
 Equipment Used :

• Rigid endoscope (0°, 30°, 70° – usually 4 mm diameter for

adults, 2.7 mm for children)
• Flexible fibreoptic endoscope (used in certain cases like
children or posterior nasal cavity)
• Light source, camera, monitor
• Nasal speculum, decongestant, and topical anaesthetic
 Preparation:

• Patient seated upright

• Nasal cavity decongested using xylometazoline or
oxymetazoline
• Topical anaesthetic (e.g., lignocaine) used
 Steps of Procedure:

1.Examine the floor of the nose

2.Middle meatus and turbinates
3.Ostiomeatal complex
4.Sphenoethmoidal recess and posterior nasal cavity
5.Nasopharynx and Eustachian tube opening
 Indications

• Chronic rhinosinusitis (esp. for ostiomeatal complex

evaluation)
• Nasal polyps or masses
• Epistaxis
• Nasal obstruction
• Suspected CSF rhinorrhea
• Preoperative and postoperative evaluation in FESS
(Functional Endoscopic Sinus Surgery)
 Advantages : Contraindications (Relative):
• Direct and detailed visualization
• Helps plan surgery (e.g., FESS) • Acute nasal trauma
• Can be performed on outpatient • Severe coagulopathy
basis • Non-cooperative patient
• Can detect early pathology not
seen in anterior rhinoscopy
LARYNGOSCOPY

• Laryngoscopy is the examination of the larynx using a mirror or

an endoscope to assess the laryngeal structures, including the
vocal cords, glottis, and subglottic area.
 Types of Laryngoscopy
1. Indirect Laryngoscopy : 2. Direct Laryngoscopy
• Done using a laryngeal mirror.
• Uses a rigid or flexible endoscope.
• Patient is seated upright.
• Done under local or general anesthesia.
• A warm mirror is placed in the oropharynx to visualize the
a. Rigid Direct Laryngoscopy
larynx.
• Performed under GA using a laryngoscope.
• Structures seen:
• Used for:
⚬ Epiglottis
⚬ Aryepiglottic folds
⚬ Biopsy

⚬ False and true vocal cords ⚬ Removal of foreign body

⚬ Interarytenoid area ⚬ Microlaryngeal surgery
⚬ Rima glottidis b. Flexible Fibreoptic Laryngoscopy
⚬ Part of subglottis • Done under local anesthesia.
• Passed through the nose to visualize the larynx.
• Useful in:
⚬ Outpatient diagnosis
⚬ Voice disorders
⚬ Assessing laryngeal movement
 Indications

• Hoarseness of voice >2 weeks

• Dysphagia
• Stridor
• Foreign body sensation
• Suspected laryngeal mass or malignancy
• Preoperative and postoperative evaluation of laryngeal
lesions
 Complications
(mainly with direct laryngoscopy): Contraindications :
• Dental injury • Uncooperative patient (for
• Trauma to lips, tongue, or pharynx indirect/fibreoptic)
• Laryngospasm • Severe bleeding diathesis (for biopsy or
• Bleeding surgery)
• Vocal cord injury (in surgery)
thank you