Nasal Polyp Surgery Workup

Updated: Jan 31, 2019
  • Author: Andrew T Cheng, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Workup

Laboratory Studies

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  • Relevant allergy or asthma studies (if indicated)

  • Nasal smears or cultures for fungus and bacteria (if indicated)

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Imaging Studies

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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. [8]

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Other Tests

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  • Olfactory testing (if indicated)

  • Medical workup for cystic fibrosis (if indicated)

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Diagnostic Procedures

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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).

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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).

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Staging

Staging is relevant in inverted papilloma with malignant transformation.

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