Otomicroscopy

• With the aid of an operating microscope and speculum, the left ear was examined. Any cerumen was cleared with a wax curette and fine suction. The procedure was then repeated on the right ear.

Cerumen removal

• With the aid of an operating microscope and speculum, the left ear was examined. Any cerumen was cleared with a wax curette and fine suction. The procedure was then repeated on the right ear.

Cerumen disimpaction

• The left ear was examined with an operating microscope and cerumen impaction noted. The cerumen was cleared using a speculum, wax curette, fine suction and alligator forceps. The external auditory canal and tympanic membrane were then examined and noted to be {NORMAL/ABNORMAL:19111:p}. The procedure was repeated for the right ear. The right external auditory canal and tympanic membrane were then examined and noted to be {NORMAL/ABNORMAL:19111:p}.

Flexible tracheobronchoscopy

• Verbal consent was obtained and a flexible fiberoptic scope was then introduced into the patient's trachea via an existing tracheostoma. The trach tube was noted to be in satisfactory position without evidence of backwalling. The carina was clearly visible and the tracheal mucosa appeared, uniformly pink and healthy. Crusting was/was not seen.
• see: Examination of the Subglottis with Transnasal Laryngoscopy

Flexible laryngoscopy

• Verbal consent was obtained and the nose sprayed with topical anesthetic and vasoconstrictor. Flexible fiberoptic scope was then introduced into the patient's nose and the nose, nasopharynx, oropharynx, larynx, and hypopharynx were then examined.
• see: Transnasal Laryngoscopy Normal Exam with High Definition and Narrow Band Imaging (NBI)

Flexible nasal endoscopy

• Verbal consent was obtained and the nose sprayed with topical anesthetic and vasoconstrictor. A flexible fiberoptic scope was then introduced into the patient's nose and the nose and examined.
• see: Internal Nasal Anatomy for Intubation - Transnasal Laryngoscopy "The High Road"/ Patulous Eustachian Tube - Management of the Symptom of Autophony

Rigid nasal endoscopy

• Verbal consent was obtained and the nose sprayed with topical anesthetic and vasoconstrictor. The nose was examined using a 0-degree rigid telescope. 

Endoscopic control of epistaxis - see Nose Bleed Management and Epistaxis Control

• Verbal consent was obtained nose was examined with the aid of a 0-degree telescope. Any blood, mucous and clot was cleared with suction. Pledgets soaked with 4% topical lidocaine and oxymetazoline were then placed into nasal passage. Following adequate anesthesia and vasoconstriction, the pledgets were removed and the telescope was used to determine the source of bleeding. A source of bleeding in the *** was identified. Hemostasis was obtained with a combination of silver nitrate and Surgicel. No further bleeding was noted. The oral cavity and oropharynx were then examined and noted to be free of blood. The patient tolerated the procedure well and without immediate complication.