Nasal Polyp Surgery Workup

  • Author: Andrew Cheng, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Mar 21, 2011
 

Laboratory Studies

  • Relevant allergy or asthma studies (if indicated)
  • Nasal smears or cultures for fungus and bacteria (if indicated)
Next

Imaging Studies

  • CT scan of sinuses without contrast: Specify coronal CT with 3-4 mm cuts and appropriate soft tissue and bone windows.
    • Evaluate the CT scan results with attention to anterior ethmoid artery, orbital and skull base anomalies, optic nerve and carotid in posterior ethmoidal (Onodi) cells, and sphenoid sinus.
    • Focus especially on previous surgical changes. Consider role and use of image-guidance system in revision or difficult cases.[3]
Previous
Next

Other Tests

  • Olfactory testing (if indicated)
  • Medical workup for cystic fibrosis (if indicated)
Previous
Next

Diagnostic Procedures

  • A nasal and sinus endoscopy with evaluation of anatomy, site of origin, past surgical changes, and evidence of other disease-causing polyps (tumor, infection, systemic diseases such as Sarcoidosis, Wegener granulomatosis) may be appropriate (see Nasal Polyps, Nonsurgical Treatment).
Previous
Next

Histologic Findings

Pseudostratified epithelium is usually found. Pay special attention to unilateral polyps that may be neoplastic, and examine them for malignancy or possible malignant transformation of benign neoplasia(20% in inverting papilloma).

Previous
Next

Staging

Staging is relevant in inverted papilloma with malignant transformation.

Previous
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Andrew Cheng, MD  Clinical Assistant Professor, Department of Otolaryngology-Head & Neck Surgery, New York Medical College

Andrew Cheng, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Medical Society of the State of New York

Disclosure: Nothing to disclose.

Specialty Editor Board

Eric J Moore, MD, FACS  Residency Director, Associate Professor, Department of Otorhinolaryngology/Head and Neck Surgery, Mayo Graduate School of Medicine

Eric J Moore, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate/Craniofacial Association, and American Head and Neck Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Nader Sadeghi, MD, FRCSC  Professor, Otolaryngology-Head and Neck Surgery, Director of Head and Neck Surgery, George Washington University School of Medicine and Health Sciences

Nader Sadeghi, MD, FRCSC is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society, American Thyroid Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

References

  1. Deal RT, Kountakis SE. Significance of nasal polyps in chronic rhinosinusitis: symptoms and surgical outcomes. Laryngoscope. Nov 2004;114(11):1932-5. [Medline].

  2. Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl. 2007;(20):1-136. [Medline].

  3. Kingdom TT, Orlandi RR. Image-guided surgery of the sinuses: current technology and applications. Otolaryngol Clin North Am. Apr 2004;37(2):381-400. [Medline].

  4. Mendelsohn D, Jeremic G, Wright E, Rotenberg E. Revision Rates After Endoscopic Sinus Surgery: A Recurrence Analysis. Ann Otol Rhinol Laryngol. March 2011;120(3):162-166.

  5. Bhattacharyya N. Progress in surgical management of chronic rhinosinusitis and nasal polyposis. Curr Allergy Asthma Rep. June 2007;3:216-20. [Medline].

  6. Garrel R, Gardiner Q, Khudjadze M, Demoly P, Vergnes C, Makeieff M. Endoscopic surgical treatment of sinonasal polyposis-medium term outcomes (mean follow-up of 5 years). Rhinology. Jun 2003;41(2):91-6. [Medline].

  7. Gosepath J, Mann WJ. Current concepts in therapy of chronic rhinosinusitis and nasal polyposis. ORL J Otorhinolaryngol Relat Spec. 2005;67(3):125-36. [Medline].

  8. Mostafa BE, Abdel Hay H, Mohammed HE, Yamani M. Role of leukotriene inhibitors in the postoperative management of nasal polyps. ORL J Otorhinolaryngol Relat Spec. 2005;67(3):148-53. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.