Nasal endoscopy assessment
Patient’s nose was decongested with co-phenylcaine forte spray 2 sprays
each nostril for 15 minutes prior to nasal endoscopic assessment. The
endoscopy was done using Hopkins II straight telescope 0 degree with a
diameter of 4mm and a length of 18 cm. The nasal endoscopy was advanced
till the nasopharynx to visualize the features of PND including
secretions at posterior nasal cavity, redness at the roof of nasopharynx
and presence of hemorrhagic spots at nasopharynx. The larynx was viewed
using a 70-degree scope with a diameter of 4mm and a length of 18 cm.
The granular posterior pharyngeal wall was assessed, and features of
reflux were scored based on the RFS tool (9). All
nasal endoscopies were recorded, and the videos were anonymized. Two
experienced rhinologists reviewed and graded the images guided by the
reference images (Figure 1-4). The assessors were blinded to the PND
status of the patient and their presenting symptoms. These two
independent assessors reviewed a group of patients for interobserver
reliability. For intra-observer reliability, the main assessor also
rescored the same group 8 weeks later.