The Otolaryngologist will assess whether he/she can optimize medical management and/or offer a surgical option. The assessment involves:
| History |
- Recurrent acute sinusitis
- Chronic sinusitis
- Immune status
- Co-morbid conditions affecting respiratory mucosa (allergy, asthma, aspirin sensitivity, polyps, Wegener’s disease, and so on)
- Previous surgery, results, and complications
- Co-morbid medical conditions (i.e., hypertension, bleeding disorders, cardiopulmonary disease)
|
| Examination |
- Anterior rhinoscopy
- Nasal endoscopy
- Nasal mucosa status (i.e., allergy, edema, polyp, crusting)
- Vestibule, valve, septum
- Inferior turbinate and meatus
- Middle turbinate and meatus: hiatus semilunaris
- Olfactory groove
- Sphenoethmoid recess, superior turbinate, and sphenoid os
- Nasopharynx
- General orbital and ocular examination
- Otorhinolaryngologic examination
- General examination
|
| Radiography |
- Coronal and axial CT scan of sinuses
- Consider magnetic resonance imaging (MRI) if potential skull base bony defect or encephalocele
|
*Modified from Cummings
et al. Otolaryngology - Head and Neck Surgery 3rd edition