Investigation of nasal diseases

Rhinological diseases are very common, and whilst an array of investigative tools exists for them, many of these are not common practice in routine ear, nose and throat (ENT) clinics. The advent of the endoscope and the significant improvements seen in the imaging and image capture technology have allowed us to better see inside the nose and beyond. This not only gives the clinician a much more comprehensive assessment of the nose and sinuses, but also facilitates education and engagement of the patients themselves as they too can see the effects of their disease and the response to any treatments. The ‘European Position Paper on Rhinosinusitis and Nasal Polyps’ (EPOS) has been a key document for guiding clinicians involved in managing chronic rhinosinusitis, and it brings guidance as to the logical flow of investigation in this condition. This chapter will lay out the full armoury of investigations available for rhinological disease that are suitable both in clinical practice and in the research domain, or even in tertiary centres. It will also give some direction as to how these fit with the EPOS guidance and a framework for investigating rhinological disease.