Thursday, 19 May 2011

Nasal Speculum - Thudichum's

The Thudichum’s nasal speculum is an instrument routinely used in the outpatient to examine the nose.

The instrument has two flanges that can be inserted into the nostril during anterior rhinoscopy. The flanges widen to open up the nasal cavity, offering a better view of the structures inside the nose.

Uses of the Thudichum’s nasal speculum:
  • In anterior rhinoscopy
  • Foreign body removal from the nose
  • Peroperatively, for nasal packing
  • In septal surgeries (septoplasty and SMR) while making the incision

How to use the Thudicum’s nasal speculum:

First, hold the instrument at its bend with your thumb and index finger.

Then, place your middle and ring fingers either side of the limbs of the speculum. Bringing these fingers close to each other will also bring the flanges of the speculum close together. Insert the instrument into the nostril in this position. Moving your middle and ring fingers apart will widen the flanges of the speculum, opening up the nasal cavity in the process.

More Information:
  • Insert the speculum fully closed into the nasal cavity, but keep the flanges slightly open while drawing the speculum out to avoid pulling any vibrissae!
  • Practice using the Thudicum’s speculum during your clinical posting, the method described above is the optimal way to best visualize the nasal cavity.
  • Structures seen on anterior rhinoscopy:
            - Nasal septum
            - Lateral wall of the nose including the turbinates and the meati
            - Floor of the nasal cavity
  • Do not use the nasal speculum to examine the vestibule. Just lift up the tip of the nose with your finger to look at the vestibule of the nose, using the speculum will only obscure it from your vision.

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