Chronic rhinosinusitis is a common condition characterized by persistent sinonasal symptoms and inflammation lasting for at least 12 weeks. Patients may present with nasal obstruction, nasal discharge, facial pressure or pain, and reduced olfactory function. Because these symptoms may overlap with other nasal and systemic disorders, objective confirmation of sinonasal inflammation is essential. Conventional rhinoscopy has limitations in visualizing deeper anatomical structures, particularly the middle meatus and areas surrounding the sinus drainage pathways. Nasal endoscopy provides enhanced visualization of these regions and allows identification of subtle inflammatory and structural abnormalities. Its diagnostic importance is particularly relevant in patients with persistent symptoms, recurrent disease, suspected nasal polyposis, or inadequate response to medical treatment. Endoscopy can also help determine whether additional imaging or surgical evaluation is required.
To evaluate the diagnostic significance of nasal endoscopy in identifying pathological changes of the nasal cavity and sinonasal structures in patients with chronic rhinosinusitis and to assess its contribution to clinical decision-making.
Patients with symptoms suggestive of chronic rhinosinusitis undergo a comprehensive otorhinolaryngological examination. The clinical assessment includes evaluation of nasal obstruction, anterior or posterior nasal discharge, facial pressure or pain, headache, olfactory dysfunction, and duration of symptoms. Nasal endoscopy is performed using a rigid or flexible endoscope following appropriate preparation of the nasal cavity. Particular attention is given to the nasal septum, inferior and middle turbinates, middle meatus, mucosal edema, purulent secretions, polyps, crusting, and anatomical variations. Endoscopic findings are documented and classified according to the severity and localization of inflammatory changes. In patients with persistent or complicated disease, computed tomography of the paranasal sinuses may be used to evaluate the extent of mucosal thickening, sinus opacification, anatomical obstruction, and osteomeatal complex involvement. Clinical symptoms, endoscopic findings, and imaging results are compared to determine the diagnostic contribution of endoscopy.
Nasal endoscopy provides detailed visualization of pathological changes that may be difficult to identify during routine examination. Edematous mucosa, purulent secretions, inflammatory changes of the middle meatus, nasal polyps, and anatomical narrowing of the sinonasal drainage pathways can be detected directly. Examination of the middle meatus is particularly valuable because inflammatory findings in this region may provide objective evidence of sinonasal disease. Endoscopy also assists in differentiating inflammatory disease from structural abnormalities that contribute to persistent nasal obstruction. In patients with nasal polyps, endoscopic examination allows assessment of their location and extent and facilitates subsequent treatment planning. When combined with computed tomography, endoscopy provides complementary information: endoscopy directly demonstrates mucosal and intranasal changes, whereas CT provides detailed visualization of deeper sinus structures and bony anatomy. Repeated endoscopic examinations may also be useful for monitoring the response to medical therapy and evaluating postoperative healing.
Nasal endoscopy is a valuable objective diagnostic method in patients with chronic rhinosinusitis. It provides direct visualization of the nasal cavity and areas that are inadequately assessed by conventional rhinoscopy, allowing identification of mucosal edema, purulent secretions, nasal polyps, and structural abnormalities. The method improves clinical assessment, supports differential diagnosis, and contributes to individualized treatment planning. Endoscopy should be interpreted together with the patient's symptoms and, when indicated, computed tomography findings rather than used as an isolated diagnostic test. Its minimally invasive nature and ability to provide immediate visual information make nasal endoscopy an important component of modern chronic rhinosinusitis evaluation.
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