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THE ROLE OF ENDOSCOPIC EXAMINATION IN EARLY DIAGNOSIS OF NASAL
POLYPS
Rus amo a E ibo Ib agimo na
Depa men o O o hinola yngology, Sama kand S a e Medical Uni e si y
h ps://doi.o g/10.5281/zenodo.17310945
In oduc ion. Nasal polyps ep esen a ch onic in lamma o y condi ion o he nasal and
pa anasal mucosa cha ac e ized by he o ma ion o benign edema ous p o usions ha lead o
nasal obs uc ion, anosmia, pos nasal d ip, and ecu en in ec ions. Thei e iology is
mul i ac o ial, in ol ing complex in e ac ions be ween ch onic in lamma ion, alle gy, in ec ion,
and gene ic p edisposi ion. Ea ly diagnosis plays a c ucial ole in imp o ing ea men ou comes
and p e en ing i e e sible mucosal changes. Howe e , adi ional diagnos ic me hods such as
an e io hinoscopy and imaging o en ail o de ec ea ly o small lesions, esul ing in delayed
managemen . Endoscopic nasal examina ion has eme ged as a highly sensi i e diagnos ic ool,
p o iding de ailed isualiza ion o he nasal ca i y and pa anasal sinus os ia, enabling ea ly
de ec ion and cha ac e iza ion o mucosal pa hology. This s udy aims o assess he clinical alue
o nasal endoscopy in he ea ly diagnosis o nasal polyps and o compa e i s diagnos ic accu acy
wi h con en ional examina ion me hods.
Objec i e The p ima y objec i e o his s udy was o de e mine he diagnos ic signi icance
o nasal endoscopy in he ea ly de ec ion o nasal polyps and o e alua e i s ole in iden i ying
subclinical o small lesions ha a e o en missed du ing an e io hinoscopy o adiog aphic
imaging. Addi ionally, he s udy aimed o es ablish he co ela ion be ween endoscopic indings
and his opa hological esul s, highligh ing he impo ance o ou ine endoscopic e alua ion in
pa ien s wi h ch onic hinosinusi is symp oms.
Ma e ials and Me hods This p ospec i e clinical s udy was conduc ed a he
O o hinola yngology Depa men o Sama kand S a e Medical Uni e si y om Janua y 2022 o
Ma ch 2024. A o al o 120 pa ien s aged 18–70 yea s wi h symp oms sugges i e o ch onic
hinosinusi is, such as nasal conges ion, acial p essu e, and dec eased sense o smell, we e
included. All pa icipan s unde wen a comple e o o hinola yngologic e alua ion including
an e io hinoscopy, nasal endoscopy using a 0° and 30° igid endoscope, and compu ed
omog aphy (CT) o he pa anasal sinuses. Endoscopic indings we e classi ied acco ding o he
Lund-Kennedy endoscopic sco ing sys em. Biopsy samples we e aken om suspicious lesions o
his opa hological con i ma ion. The diagnos ic yield o endoscopy was compa ed wi h ha o
an e io hinoscopy and CT imaging. S a is ical analysis was pe o med using SPSS so wa e; p-
alues less han 0.05 we e conside ed s a is ically signi ican .
Resul s Nasal endoscopy iden i ied polyps in 82 ou o 120 pa ien s (68.3%), whe eas
an e io hinoscopy de ec ed only 54 cases (45%), demons a ing a signi ican ly highe sensi i i y
o endoscopic examina ion (p<0.001). Among he endoscopically de ec ed cases, 24 (29.3%)
ep esen ed ea ly-s age polyps con ined o he middle mea us o e hmoidal ecess, which we e no
isible on an e io hinoscopy. CT imaging con i med he p esence o sinonasal mucosal
hickening o polyposis in 74 cases (61.6%), consis en wi h endoscopic indings in 68 pa ien s
(91.9%). His opa hological examina ion e i ied he p esence o in lamma o y nasal polyps in 79
cases (96.3% o endoscopic de ec ions). The mean endoscopic Lund-Kennedy sco e was 4.6 ± 1.2
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in ea ly-s age disease and 8.1 ± 1.5 in ad anced disease, showing a di ec co ela ion be ween
endoscopic g ading and disease se e i y ( =0.74, p<0.001). The s udy also e ealed ha ea ly
endoscopic de ec ion allowed medical managemen o be ini ia ed in 22 pa ien s, p e en ing
p og ession o ex ensi e polyposis equi ing su ge y.
Discussion The esul s o his s udy con i m ha nasal endoscopy signi ican ly enhances
he diagnos ic accu acy o nasal polyps compa ed o adi ional examina ion me hods. I allows o
di ec isualiza ion o he nasal ca i y, enabling de ec ion o small o hidden lesions in a eas ha
a e inaccessible o an e io hinoscopy. Mo eo e , endoscopic examina ion p o ides aluable
in o ma ion abou he ex en o mucosal in lamma ion, ana omical a ia ions, and pa ency o sinus
os ia, all o which a e c ucial o planning app op ia e he apeu ic in e en ions. Ea ly
iden i ica ion o polyps acili a es imely ini ia ion o medical he apy such as co icos e oid nasal
sp ays o sys emic an i-in lamma o y agen s, po en ially educing he need o su gical
in e en ion. The high co ela ion be ween endoscopic and his opa hological indings unde sco es
he eliabili y o endoscopy as bo h a diagnos ic and ollow-up ool. While CT imaging emains
essen ial o su gical planning, i canno eplace he de ailed mucosal assessmen p o ided by
endoscopy. The e o e, nasal endoscopy should be conside ed an indispensable pa o he
diagnos ic algo i hm o pa ien s p esen ing wi h ch onic nasal symp oms.
Conclusion Endoscopic examina ion plays a pi o al ole in he ea ly diagnosis and
managemen o nasal polyps. I o e s supe io sensi i i y and speci ici y compa ed o
con en ional diagnos ic me hods, enabling clinicians o iden i y ea ly-s age lesions ha a e o en
missed by an e io hinoscopy. The s udy demons a es ha inco po a ing nasal endoscopy in o
ou ine clinical e alua ion o pa ien s wi h ch onic hinosinusi is symp oms esul s in ea lie
de ec ion, imp o ed he apeu ic ou comes, and educed p og ession o ad anced disease. Regula
use o nasal endoscopy, in combina ion wi h imaging and his opa hology, o ms he co ne s one o
mode n hinologic diagnos ics and should be emphasized in bo h clinical p ac ice and
pos g adua e medical aining o enhance pa ien ca e ou comes.
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