Fast Five Quiz: Nasal Polyp Practice Essentials

Arlen D. Meyers, MD, MBA

Disclosures

May 14, 2020

Coronal sinus CT scanning is the imaging study of choice in the evaluation of patients with nasal polyposis. Coronal CT scanning of the paranasal sinuses is best for delineating the underlying disease, the extent of disease, and possible bony destruction. Nonenhanced CT scanning with 2- to 3-mm sections helps to delineate the location and origin of the visible polyps, evaluate the underlying condition of all of the sinuses, and assess the anatomy of the paranasal sinuses in the event of surgical intervention.

MRI is not an appropriate imaging modality for nasal polyposis unless intracranial extension is suspected. Bony details of the paranasal sinus anatomy are poorly visualized on MRI. Radiography with Waters' views may show opacification of the sinuses.

Nasal endoscopy in an office setting can sometimes be helpful in the diagnosis and evaluation of nasal polyps. This technique helps illuminate the nasal cavity and improves visualization of the dark recesses of the cavity. Endoscopy may allow the examiner to see beyond an obstructing nasal septal deviation, an enlarged turbinate, or an obstructing polyp.

Biopsy is not always required for the diagnosis of nasal polyps. Nasal masses that do not have the classic appearance of bilateral nasal polyps or do not respond to conservative treatment should be examined with careful biopsy for diagnosis. The histologic appearance of nasal polyps varies from edematous tissue with a few glands to an increase in glandular elements. Eosinophils may be present, indicating an allergic component.

Read more about the workup of patients with nasal polyps.

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