THE ROLE OF ENDOSCOPIC EXAMINATION IN EARLY DIAGNOSIS OF NASAL POLYPS

Oktabr, 2025-Yil 37 THE ROLE OF ENDOSCOPIC EXAMINATION IN EARLY DIAGNOSIS OF NASAL POLYPS Rustamova Etibor Ibragimovna Department of Otorhinolaryngology, Samarkand State Medical University https://doi.org/10.5281/zenodo.17310945 Introduction. Nasal polyps represent a chronic inflammatory condition of the nasal and paranasal mucosa characterized by the formation of benign edematous protrusions that lead to nasal obstruction, anosmia, postnasal drip, and recurrent infections. Their etiology is multifactorial, involving complex interactions between chronic inflammation, allergy, infection, and genetic predisposition. Early diagnosis plays a crucial role in improving treatment outcomes and preventing irreversible mucosal changes. However, traditional diagnostic methods such as anterior rhinoscopy and imaging often fail to detect early or small lesions, resulting in delayed management. Endoscopic nasal examination has emerged as a highly sensitive diagnostic tool, providing detailed visualization of the nasal cavity and paranasal sinus ostia, enabling early detection and characterization of mucosal pathology. This study aims to assess the clinical value of nasal endoscopy in the early diagnosis of nasal polyps and to compare its diagnostic accuracy with conventional examination methods. Objective The primary objective of this study was to determine the diagnostic significance of nasal endoscopy in the early detection of nasal polyps and to evaluate its role in identifying subclinical or small lesions that are often missed during anterior rhinoscopy or radiographic imaging. Additionally, the study aimed to establish the correlation between endoscopic findings and histopathological results, highlighting the importance of routine endoscopic evaluation in patients with chronic rhinosinusitis symptoms. Materials and Methods This prospective clinical study was conducted at the Otorhinolaryngology Department of Samarkand State Medical University from January 2022 to March 2024. A total of 120 patients aged 18–70 years with symptoms suggestive of chronic rhinosinusitis, such as nasal congestion, facial pressure, and decreased sense of smell, were included. All participants underwent a complete otorhinolaryngologic evaluation including anterior rhinoscopy, nasal endoscopy using a 0° and 30° rigid endoscope, and computed tomography (CT) of the paranasal sinuses. Endoscopic findings were classified according to the Lund-Kennedy endoscopic scoring system. Biopsy samples were taken from suspicious lesions for histopathological confirmation. The diagnostic yield of endoscopy was compared with that of anterior rhinoscopy and CT imaging. Statistical analysis was performed using SPSS software; pvalues less than 0.05 were considered statistically significant. Results Nasal endoscopy identified polyps in 82 out of 120 patients (68.3%), whereas anterior rhinoscopy detected only 54 cases (45%), demonstrating a significantly higher sensitivity for endoscopic examination (p<0.001). Among the endoscopically detected cases, 24 (29.3%) represented early-stage polyps confined to the middle meatus or ethmoidal recess, which were not visible on anterior rhinoscopy. CT imaging confirmed the presence of sinonasal mucosal thickening or polyposis in 74 cases (61.6%), consistent with endoscopic findings in 68 patients (91.9%). Histopathological examination verified the presence of inflammatory nasal polyps in 79 cases (96.3% of endoscopic detections). The mean endoscopic Lund-Kennedy score was 4.6 ± 1.2 Oktabr, 2025-Yil 38 in early-stage disease and 8.1 ± 1.5 in advanced disease, showing a direct correlation between endoscopic grading and disease severity (r=0.74, p<0.001). The study also revealed that early endoscopic detection allowed medical management to be initiated in 22 patients, preventing progression to extensive polyposis requiring surgery. Discussion The results of this study confirm that nasal endoscopy significantly enhances the diagnostic accuracy of nasal polyps compared to traditional examination methods. It allows for direct visualization of the nasal cavity, enabling detection of small or hidden lesions in areas that are inaccessible to anterior rhinoscopy. Moreover, endoscopic examination provides valuable information about the extent of mucosal inflammation, anatomical variations, and patency of sinus ostia, all of which are crucial for planning appropriate therapeutic interventions. Early identification of polyps facilitates timely initiation of medical therapy such as corticosteroid nasal sprays or systemic anti-inflammatory agents, potentially reducing the need for surgical intervention. The high correlation between endoscopic and histopathological findings underscores the reliability of endoscopy as both a diagnostic and follow-up tool. While CT imaging remains essential for surgical planning, it cannot replace the detailed mucosal assessment provided by endoscopy. Therefore, nasal endoscopy should be considered an indispensable part of the diagnostic algorithm for patients presenting with chronic nasal symptoms. Conclusion Endoscopic examination plays a pivotal role in the early diagnosis and management of nasal polyps. It offers superior sensitivity and specificity compared to conventional diagnostic methods, enabling clinicians to identify early-stage lesions that are often missed by anterior rhinoscopy. The study demonstrates that incorporating nasal endoscopy into routine clinical evaluation of patients with chronic rhinosinusitis symptoms results in earlier detection, improved therapeutic outcomes, and reduced progression to advanced disease. 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