Simply stated, fiberoptic rhinopharyngolaryngoscopy (rhinoscopy, for short) is a new technique for examining the nose and throat. When your primary doctor examines your nose and throat, only the front portion can be seen. Many diagnoses can be made by examining this area. But as we all know, complaints of nasal congestion, post-nasal drainage, itching, bleeding and pain can occur further back in the nose and certainly down the throat.

With the rhinoscope your doctor can examine the entire nasal passage, including the eustachian tube openings of the ear canal to the throat. He can also examine the tonsils and adenoids to determine size or look for infection, and be sure that the vocal cords are normal without nodules or blockage. He can also check the back of the throat above the vocal cords for signs of acid reflux (gastroesophageal reflux or GERD), a common trigger of asthma and one of the most common causes of chest pain.

Allergists and ENT doctors are the specialists trained to use rhinoscopes. The rhinoscope is a small, flexible plastic tube with fiberoptics for viewing the airway. The rhinoscope can be attached to a television camera to provide a permanent record of your examination.

To do the exam, a decongestant (usually Afrin) is sprayed into the nose first, followed by a local anesthetic (usually lidocaine) to numb the area. As the scope enters the nose, you will feel that it’s there and a little uncomfortable, but it won’t hurt. Sometimes the lidocaine drips down the back of the nose and numbs the throat; this usually goes away in a few minutes. If your examination has been recorded, your doctor can review the recording with you, if you wish.

Rhinoscopy can be performed if you have asthma, but it is best for your breathing to be well controlled at the time of the exam. Recently, doctors have discovered an unusual disorder of the larynx and vocal cords, which mimics asthma. Rhinoscopy can then be used to examine the airway and cords and make the appropriate diagnosis.

What if something’s wrong with your nose or throat? Many nasal disorders respond well to medication. If any abnormality is found that is not likely to respond to medication, or if your allergist has questions about your examination, you will be referred to an ENT specialist.