Definition: This is a procedure used to examine the posterior part of the nasal cavity and nasopharynx. Procedure:
- The mouth is opened. The tongue is depressed by means of a tongue depressor, the mirror is dipped in antifog solution or warmed over the flame to avoid deposition of moisture.
- A posterior rhinoscopy mirror is then passed behind the soft palate with the mirror facing upwards.
- The patient is then told to relax and take deep breaths.
- Laterally: Eustachian tube opening is seen on the posterior end of the inferior turbinate.
- Medially: Posterior end of middle, inferior and superior turbinates and posterior part of septum.
- Inferiorly: End posterior surface of the soft palate.
- Rosenmullers fossa is seen behind the Eustachian tube.
Problems in Posterior Rhinoscopy In about 20% of the patients it is not possible to examine the postnasal space by posterior rhinoscopy mirror. A nasopharyngoscopy (fibre-optic) or rigid endoscopy in preferred in such cases. The nasopharynx can also be visualized by diagnostic FESS. Gag Reflex: In some sensitive patients this prevents proper examinations. Children are usually not very co-operative in this procedure.