Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T13:07:27.030Z Has data issue: false hasContentIssue false
  • English
  • Français

Nasal and instrument preparation prior to rigid and flexible nasendoscopy: a systematic review

Published online by Cambridge University Press:  20 May 2008

P C Nankivell  and
D D Pothier
P C Nankivell*
Affiliation:
Department of Otolaryngology, Gloucestershire Royal Hospital, Gloucester, UK
D D Pothier
Affiliation:
Department of Otolaryngology, Royal United Hospital, Bath, UK
*
Address for correspondence: Mr Paul Nankivell, Department of Otolaryngology, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Examination of the upper aerodigestive tract is an important part of ENT practice. The use of both flexible and rigid nasendoscopes is the most common way of achieving this in the out-patient setting. However, these procedures can cause pain or discomfort for the patient, and topical preparations have been used in an attempt to reduce this.

Objectives:

The variability in current practice amongst those performing nasendoscopy may suggest an uncertainty as to what constitutes best practice for this procedure. A systematic review of the literature was undertaken in an attempt to clarify this.

Methods:

A literature search of the Cochrane ENT group trials register, the Cochrane central register of controlled trials (CENTRAL), CINAHL (1982–2007), MEDLINE (1950–2007) and EMBASE (1974–2007) was performed. Reference lists of selected studies were scanned for additional research material.

Results:

Eighteen studies relevant to this review were identified. The evidence suggests that local anaesthetic is not beneficial when performing flexible nasendoscopy, neither alone nor in combination with a vasoconstrictor. Water is better than lubricant for flexible endoscope passage and gives a superior optical outcome. Further research is required on the use of endosheaths for flexible and rigid nasendoscopy.

Keywords

EndoscopyNoseAnaesthesiaDrug AdministrationTopical
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 10 , October 2008 , pp. 1024 - 1028
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Linder, TE, Simmen, D, Stool, SE. Revolutionary inventions in the 20th century. The history of endoscopy. Arch Otolaryngol Head Neck Surg 1997;123:1161–3CrossRefGoogle ScholarPubMed
2 Sawashima, M, Hirose, H. New laryngoscopic technique by use of fiber optics. J Acoust Soc Am 1968;43:168–9CrossRefGoogle ScholarPubMed
3 De, R, Uppal, HS, Shehab, ZP, Hilger, AW, Wilson, PS, Courteney-Harris, R. Current practices of cocaine administration by UK otorhinolaryngologists. J Laryngol Otol 2003;117:109–12CrossRefGoogle ScholarPubMed
4 Latorre, F, Klimek, L. Does cocaine still have a role in nasal surgery? Drug Safety 1999;20:9–13CrossRefGoogle ScholarPubMed
5 Frosh, AC, Jayaraj, S, Porter, G, Almeyda, J. Is local anaesthesia actually beneficial in flexible fibreoptic nasendoscopy? Clin Otolaryngol Allied Sci 1998;23:259–62CrossRefGoogle ScholarPubMed
6 Leder, SB, Ross, DA, Briskin, KB, Sasaki, CT. A prospective, double-blind, randomized study on the use of a topical anesthetic, vasoconstrictor, and placebo during transnasal flexible fiberoptic endoscopy. J Speech Lang Hear Res 1997;40:1352–7CrossRefGoogle Scholar
7 Sadek, SA, De, R, Scott, A, White, AP, Wilson, PS, Carlin, WV. The efficacy of topical anaesthesia in flexible nasendoscopy: a double-blind randomised controlled trial. Clin Otolaryngol Allied Sci 2001;26:25–8CrossRefGoogle ScholarPubMed
8 Jonas, NE, Visser, MF, Oomen, A, Albertyn, R, van Dijk, M, Prescott, CA. Is topical local anaesthesia necessary when performing paediatric flexible nasendoscopy? A double-blind randomized controlled trial. Int J Pediatr Otorhinolaryngol 2007;71:1687–92CrossRefGoogle ScholarPubMed
9 Georgalas, C, Sandhu, G, Frosh, A, Xenellis, J. Cophenylcaine spray vs. placebo in flexible nasendoscopy: a prospective double-blind randomised controlled trial. Int J Clin Prac 2005;59:130–3CrossRefGoogle ScholarPubMed
10 Cain, AJ, Murray, DP, McClymont, LG. The use of topical nasal anaesthesia before flexible nasendoscopy: a double-blind, randomized controlled trial comparing cophenylcaine with placebo. Clin Otolaryngol Allied Sci 2002;27:485–8CrossRefGoogle ScholarPubMed
11 Singh, V, Brockbank, MJ, Todd, GB. Flexible transnasal endoscopy: is local anaesthetic necessary? J Laryngol Otol 1997;111:616–18CrossRefGoogle ScholarPubMed
12 Johnson, PE, Belafsky, PC, Postma, GN. Topical nasal anesthesia for transnasal fiberoptic laryngoscopy: a prospective, double-blind, cross-over study. Otolaryngology Head Neck Surg 2003;128:452–4Google ScholarPubMed
13 Kasemsuwan, L, Griffiths, MV. Lignocaine with adrenaline: is it as effective as cocaine in rhinological practice? Clin Otolaryngol Allied Sci 1996;21:127–9CrossRefGoogle ScholarPubMed
14 Smith, JC, Rockley, TJ. A comparison of cocaine and ‘co-phenylcaine’ local anaesthesia in flexible nasendoscopy. Clin Otolaryngol Allied Sci 2002;27:192–6CrossRefGoogle ScholarPubMed
15 Lennox, P, Hern, J, Birchall, M, Lund, V. Local anaesthesia in flexible nasendoscopy. A comparison between cocaine and co-phenylcaine. J Laryngol Otol 1996;110:540–2CrossRefGoogle ScholarPubMed
16 Pothier, DD, Awad, Z, Whitehouse, M, Porter, GC. The use of lubrication in flexible fibreoptic nasendoscopy: a randomized controlled trial. Clin Otolaryngol Allied Sci 2005;30:353–6CrossRefGoogle ScholarPubMed
17 Pothier, DD, Raghava, N, Monteiro, P, Awad, Z. A randomized controlled trial: is water better than a standard lubricant in nasendoscopy? Clin Otolaryngol Allied Sci 2006;31:134–7CrossRefGoogle ScholarPubMed
18 Winter, SC, Thirwell, A, Jervis, P. Flexible nasendoscope with a disposable-sheath system versus standard nasendoscopy: a prospective, randomized trial. Clin Otolaryngol Allied Sci 2002;27:81–3CrossRefGoogle ScholarPubMed
19 Vaz, F, Ripley, L, Lim, D, Kanegaonkar, R, Harries, M. Optical quality of the nasendoscope with and without the endosheath. J Laryngol Otol 2006;120:385–8CrossRefGoogle ScholarPubMed
20 Walshe, P, Rowley, H, Hone, S, Timon, C. Co-phenylcaine as an alternative to Brompton's solution in rigid nasendoscopy: a pilot study. J Clin Pharm Ther 2002;27:185–7CrossRefGoogle ScholarPubMed
21 Douglas, R, Hawke, L, Wormald, PJ. Topical anaesthesia before nasendoscopy: a randomized controlled trial of co-phenylcaine compared with lignocaine. Clin Otolaryngol Allied Sci 2006;31:33–5CrossRefGoogle ScholarPubMed
22 Pothier, DD, Hall, CE, Gillett, S, Nankivell, P. Timing of co-phenylcaine administration before rigid nasendoscopy: a randomized, controlled trial. J Laryngol Otol 2007;121:228–30CrossRefGoogle ScholarPubMed