Last reviewed: 23 Aug 2023
Last updated: 17 May 2022
Summary
Definition
History and exam
Key diagnostic factors
- nasal obstruction
- nasal discharge
- facial pain/pressure
- direct visualization
More key diagnostic factors
Other diagnostic factors
- reduced sense of smell/anosmia
- cough
Other diagnostic factors
Risk factors
- asthma
- eosinophilic granulomatous polyangiitis (EGPA, also known as Churg-Strauss syndrome)
- allergic fungal rhinosinusitis (AFRS)
- aspirin sensitivity
- genetic predisposition
More risk factors
Diagnostic investigations
1st investigations to order
- anterior rhinoscopy
- nasal endoscopy
More 1st investigations to order
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
More investigations to consider
Treatment algorithm
ACUTE
mild to moderate polyposis (VAS 0-7)
severe polyposis (VAS >7)
Contributors
Authors
Hesham A. Saleh, MBBCh, FRCS, FRCS (ORL-HNS)

Consultant Rhinologist
Charing Cross Hospital
Professor of Practice in Rhinology
Imperial College
London
UK
Disclosures
HAS declares that he has no competing interests.
Guy Scadding, FRCP, PhD
Consultant Allergist
Royal Brompton and Harefield NHS Trust
London
UK
Disclosures
GS declares that he has no competing interests.
Acknowledgements
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.
Disclosures
RJDH and RK declare that they have no competing interests.
Peer reviewers
Sietze Reitsma, MD, PhD
Rhinologist
Amsterdam University Medical Centers
Amsterdam
Netherlands
Disclosures
SR declares that he has no competing interests.
Differentials
- Neoplasm
- Congenital lesions (e.g., encephalocele, concha bullosa)
- Foreign body
More DifferentialsGuidelines
- European position paper on rhinosinusitis and nasal polyps 2020
- Canadian clinical practice guidelines for acute and chronic rhinosinusitis
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