RINOSKOPIYA

From Big Medical Encyclopedia

RINOSKOPIYA (Greek rhis, rhinos a nose + skopeo to consider, investigate) — a method of a research of a nasal cavity by means of nasal mirrors (nasal dilators) and a nasopharyngeal mirror. Distinguish the front, average and back River. Front and back R. were developed in 1860 by I. Chermak, to-ry then offered the term «rinoskopiya». Average R. is developed by G. Killian.

Rubles make at artificial lighting. At children of younger age for R. use nasal mirrors of the smaller sizes or ear speculums (see. Otorhinolaryngological tools ). Before R. previously examine a threshold of a cavity nose (see). For this purpose raise a tip of a nose a thumb at the head rejected back to exclude existence of cracks, eczemas, a furuncle.

Front rinoskopiya

Fig. 1. Position of the patient and doctor during the carrying out a front rinoskopiya.

The doctor sits opposite to the patient, to the right of to-rogo at the level of an ear the light source is located. The head of the patient is fixed, covering a palm of one hand occipitoparietal area, and other hand carefully enter a nasal mirror in closed form into a threshold of a nasal cavity of sick (fig. 1) on distance of 3 — 5 — 10 — 20 mm (depending on age). Then gradually, without hurting, move apart branches of a nasal mirror. At front R.'s carrying out 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 the front River. At R. in the first position (the head of the patient is in direct situation) lobbies otde-"ly a bottom of a nasal cavity examine, its partition, the lower and general nasal courses, the front end of the lower nasal sink. After greasing of a mucous membrane vasoconstrictors (solutions of ephedrine, adrenaline, etc.) and at a wide nasal cavity it is possible to see a back wall of a nasopharynx in this position (a nasal part of a throat, T.).

In the second position (the head of the patient is thrown back back) it is possible to examine front horses, an average nasal sink, average department of a partition of a nose, the average nasal course, a big trellised bubble (bulla ethmoid alis).

An average rinoskopiya

At average R. position of the doctor and patient same as well as during the carrying out the front River. Average R. is made a nasal mirror of Killian with the extended branches (50 — 1jlmm), a cut enter into a nasal cavity in closed form after preliminary anesthesia of a mucous membrane of a nose and especially average nasal course of 5% solution of cocaine, 1 — 2% solution of a xycain (xylocainum), etc., sometimes with addition of vasoconstrictors. Then, carefully moving apart shutters of a mirror, push aside an average nasal sink towards a partition of a nose then examine the average nasal course, a semi-lunar crevice (hiatus semilunaris), openings of the frontal sinus, front and average bosoms of a sievebone and Highmore's (maxillary, T.) bosoms. 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 examine above all olfactory furrow, behind — an apertura sinus sphenoidalis.

Back rinoskopiya

Fig. 2. Diagrammatic representation of carrying out a back rinoskopiya: the pallet remove language from top to bottom, get a nasopharyngeal mirror for a uvula: 1 — a uvula; 2 — a nasopharyngeal mirror; 3 — language; 4 — the pallet.
Fig. 3. The diagrammatic representation of a front wall of a nasopharynx at a back rinoskopiya: 1 — an upper nasal sink; 2 — an average nasal sink; 3 — the lower nasal sink; 4 — a uvula.

The back rinoskopiya (rinofaringoskopiya) is used for a research of back departments of a nasal cavity, survey to-rykh not always well works well at average R. Primenyaya a set of nasopharyngeal mirrors of different diameter with a corner between a mirror and a core in 100 — 120 °, examine a nasal cavity from a nasopharynx. The pallet taken in the left hand remove front two thirds of language of the patient from top to bottom, and the right hand enter the nasopharyngeal mirror which is previously slightly warmed up and turned by a specular surface up, almost to a back wall of a throat (fig. 2) to avoid emergence of an emetic reflex, sick suggest to breathe quietly a nose at widely open 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 back R.'s carrying out the mucous membrane of a back wall of a throat and a nasopharynx is irrigated or greased with the anesthetizing solutions.

For back R.'s carrying out also the fiberscope or a special tip and the lighter entering «A set of mirrors otolaryngologic with a fiber optics» use.

At back R. it is possible to examine a vault of the farynx, a share, a postnaris, the back ends of nasal sinks (fig. 3), the mouth eustachian (acoustical, T.) pipes, rozenmyullerovsky poles (pharyngeal pockets, T.), back surface of a soft palate.

See also Inspection of the patient .



Bibliography: Dobromydsky F. I. By century of a method of a rinoskopiya, Vestn. otorinolar., No. 5, page 80, 1959; The Priest V. A., Banar I. M. and Ma N yu to M. K. Fibroepifaringoskopiya — a method of a research of a nasopharynx, Zhurn. ushn., nose. and throats, Bol., No. 5, page 55, 1980; Czermak J. N. t)ber die Inspektion des Cavum pharyngo-nasale und der Nasenhohle durch Choanen vermittelst kleiner Spiegel, Wien. med. Wschr., S. 519, 1859, S. 257, 1860; Messerkl inger W. Endoscopy of the nose, Baltimore — Munich, 1978.


I. L. Kruchinina.

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