Laboratory Studies
See the list below:
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Relevant allergy or asthma studies (if indicated)
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Nasal smears or cultures for fungus and bacteria (if indicated)
Imaging Studies
See the list below:
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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. [10]
Other Tests
See the list below:
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Olfactory testing (if indicated)
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Medical workup for cystic fibrosis (if indicated)
Diagnostic Procedures
See the list below:
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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).
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).
Staging
Staging is relevant in inverted papilloma with malignant transformation.
