Evidence Checklist: Nasal Polyps

CT scan of paranasal sinuses documenting polyp extentCritical

CT imaging is essential for evaluating the extent of nasal polyposis, showing opacification of the ethmoid and maxillary sinuses, polyp burden, and anatomical obstruction. The Lund-Mackay score helps grade severity.

ENT evaluation with nasal endoscopyCritical

Otolaryngologist examination with nasal endoscopy directly visualizing and characterizing the polyps — size, extent, unilateral vs. bilateral, and presence in the middle meatus vs. extending to the choana.

Nexus opinion linking nasal polyps to service ("at least as likely as not")Critical

A medical opinion connecting your nasal polyps to in-service allergic rhinitis, chronic sinusitis, aspirin-exacerbated respiratory disease (AERD), or chemical/inhalational exposures during service.

Allergy testing documenting atopic basis

Skin-prick or specific IgE testing documenting allergic sensitization that may be driving chronic eosinophilic inflammation and polyp formation, strengthening the nexus to service-related allergen exposures.

Treatment records (nasal steroids, biologics, surgery)

Records documenting intranasal corticosteroids, systemic steroids, dupilumab or other biologic therapy, and any endoscopic sinus surgery (FESS) with polypectomy, including operative reports.

Documentation of polyp recurrence after surgery

Post-surgical endoscopy or imaging showing recurrence of polyps following surgical removal, demonstrating the chronic nature and severity of the condition.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Completed DBQ Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx, and PharynxCritical

Standardized form capturing endoscopy findings, polyp extent, treatment history, and functional impact of nasal polyps.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.