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Multidisciplinary Consensus Statement for Appropriate Evaluation and Workup of Sinonasal Masses
Nyall R London1,2,3,4, Jerlon Chiu2, Neal S Akhave5
1Sinonasal and Skull Base Tumor Section, Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Importance:
Suboptimal practices in the evaluation and workup of nasal masses may lead to patient outcomes that could be improved. Recognizing common pitfalls and mishandled clinical scenarios underscores the need for clear, consensus-driven recommendations.
Objective:
To provide expert consensus recommendations regarding the appropriate workup and evaluation of nasal masses to avoid common pitfalls, optimize management practices, and ultimately improve patient outcomes.
Design, Setting, And Participants:
A systematic review from 1990 to 2025 was conducted in PubMed to identify gaps and discrepancies in practice guidelines and to assist in the development of consensus statements. Expert physicians from both academic and private practice environments from the US, UK, and Canada were identified and included specialties of comprehensive otolaryngology, head and neck surgery, rhinology, neurosurgery, and medical oncology. A modified Delphi approach was used to conduct an expert consensus survey. The statement generation and surveys were conducted from February 2025 to June 2025.
Main Outcome And Measure:
The formulation and expert evaluation of 23 consensus statements.
Results:
A total of 25 multidisciplinary experts, including 17 male and 8 female physicians spanning comprehensive otolaryngology (n = 3), head and neck surgery (n = 7), rhinology (n = 12), neurosurgery (n = 1), and medical oncology (n = 2), participated in the survey. Of the 23 statements, 20 reached consensus during the initial iteration among the initial evaluation, biopsy, imaging, pathologic evaluation, and additional workup subgroups. Two of these statements underwent revision and were ultimately accepted, while the last statement did not achieve expert consensus.
Conclusions And Relevance:
This multidisciplinary expert consensus statement can guide physicians and medical practitioners in adopting the proper evaluation and workup of nasal masses, helping them to avoid common pitfalls, optimize management practices, and ultimately improve patient outcomes.
