How to Evaluate a Sinonasal Mass: Key Recommendations from a Multidisciplinary Consensus

Introduction and Context

Nasal cavity and paranasal sinus masses are common clinical findings, ranging from benign inflammatory polyps to rare but aggressive malignancies. Mistakes in the initial evaluation—missed imaging, inappropriate or blind biopsy, or inadequate pathology workup—can delay diagnosis, cause complications, or misdirect treatment. To address these issues, a multidisciplinary expert panel published a consensus statement in JAMA Otolaryngology—Head & Neck Surgery (London et al., 2026) with 23 proposed recommendations for the evaluation and workup of sinonasal masses. This article synthesizes the core guidance, highlights what changed or was emphasized compared with prior practice patterns, and translates the recommendations into actionable steps for clinicians.

Why this consensus now? Advances in imaging, endoscopic techniques, and tumor molecular diagnostics, plus recognition of frequent diagnostic pitfalls, made an updated, multidisciplinary approach necessary. The consensus was developed following a systematic literature review (1990–2025) and a modified Delphi process involving otolaryngologists (general, rhinology, head and neck), neurosurgery, and medical oncology from North America and the UK.