Last reviewed:September 2019
Last updated:February  2019

Summary

Definition

History and exam

Key diagnostic factors

  • nasal obstruction
  • nasal discharge
  • facial pain/pressure
  • direct visualization

Other diagnostic factors

  • reduced sense of smell/anosmia
  • cough

Risk factors

  • asthma
  • eosinophilic granulomatous polyangiitis (EGPA, also known as Churg-Strauss syndrome)
  • allergic fungal rhinosinusitis (AFRS)
  • aspirin sensitivity
  • genetic predisposition

Diagnostic investigations

1st investigations to order

  • anterior rhinoscopy
  • nasal endoscopy
Full details

Investigations to consider

  • CT sinuses
  • biopsy
  • nasal smear and culture
  • CBC with differential
  • antineutrophil cytoplasm antibodies (ANCA)
  • erythrocyte sedimentation rate (ESR)
  • skin prick tests/serum allergen-specific IgE tests
  • nasal airway assessment
  • aspirin challenge
  • olfaction studies
  • quality-of-life measures
Full details

Treatment algorithm

Contributors

Hesham A. Saleh

Consultant Rhinologist

Charing Cross Hospital

Honorary Senior Lecturer

Imperial College

London

UK

Disclosures

HAS declares that he has no competing interests.

Consultant Allergist

Royal Brompton and Harefield NHS Trust

London

UK

Disclosures

GS declares that he has no competing interests.

Dr Hesham A. Saleh and Dr Guy Scadding would like to gratefully acknowledge Dr Richard J. D. Hewitt and Dr Romana Kuchai, previous contributors to this topic. RJDH and RK declare that they have no competing interests.

Peer reviewersVIEW ALL

Rhinologist

Amsterdam University Medical Centers

Amsterdam

Netherlands

Disclosures

SR declares that he has no competing interests.

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