Can CT Scan Detect Nasal Polyps ?

A search of PubMed for 1980-2017 with the search-terms “nasal polyposis” and “nasal polyps” found no studies of CT imaging of nasal polyposis as clinically defined. There are not even any sections focusing on imaging of “chronic rhinosinusitis withy polyps” in any of the international position papers 

Many articles, on the other hand, have studied and classified ethmoidal and sinus opacity in chronic rhinosinusitis without and without polyps: no correlations emerged between CT aspect and clinical presentation. The various position papers advise against founding diagnosis of chronic rhinosinusitis on CT alone rather than on chronic symptomatology, with endoscopy to distin¬guish rhinosinusitis with and without polyps. However, not all functional disorders of the nose are due to inflammation, and the term “chronic nasal dysfunction” seems more appropriate than “chronic rhinosinusitis” as an a-priori designation of nasal functional pathology as such and to assess its specific impact on quality of life

Nasal and sinus CT does, however, enable the concept of chronic rhinosinusitis to be reconsidered in the light of the new concepts of evo-devo theory  and sinusology. The hypothesis of sinus ventilation renewing the “intrasinus air” derives from the late 19th century description of cavities devel¬oping from and dependent on the nasal cavities. There are, however, few studies in healthy volunteers seeking to confirm this sinus ventilation in the strict sense of the term (i.e., renewal of intra-sinus air by nasal cavity air), and their conclusions have been unsure and unconvincing . Probable ostial dysfunction due to eosinophil inflammation in polyposis further hinders under¬standing of frontal and maxillary sinus ventilation.

On the other side, The radio-opacities caused by nasal polyposis confirmed on endoscopy, are basically ethmoidal. They support the findings of exploration during endoscopic surgery to determine the origin of the polyps, showing that they are clearly of ethmoidal origin, prolapsing into the middle meatus and/or the olfactory groove.

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