What criteria should I use to decide when to refer a patient with nasal polyps to an ENT specialist?

Criteria for referral of a patient with nasal polyps to an ear, nose, and throat (ENT) specialist include:

• Presence of nasal polyps causing significant symptoms such as nasal obstruction, anosmia, or recurrent sinus infections that do not respond to initial medical treatment.
• Failure to respond to appropriate medical management including intranasal corticosteroids and other conservative therapies.
• Suspicion of complications or associated conditions such as asthma or aspirin-exacerbated respiratory disease requiring specialist assessment.
• Unilateral nasal polyps or atypical presentation that may raise concern for neoplastic processes, warranting specialist evaluation.
• Need for surgical intervention or further diagnostic investigations such as nasal endoscopy or imaging.

While the provided UK guidelines do not explicitly list referral criteria for nasal polyps, standard clinical practice and ENT referral pathways recommend referral under these circumstances to ensure appropriate specialist management and exclusion of serious pathology.