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The initial evaluation for sinusitis or nasal allergies begins with a complete history and physical exam of the head and neck region. In the majority of cases, this evaluation will also include a nasal endoscopy to study the internal structures of the nasal cavity. Sometimes it may also be necessary to obtain radiological imaging such as a CT scan. In cases where there is active infection, a culture may be necessary. The specialist can then reach a diagnosis after considering all of this information.