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Head, neck and oral biopsy

Nasal and Sinus Biopsy: — What Happens During the Procedure

A nasal or sinus biopsy takes a small piece of tissue so the laboratory can examine it under a microscope. Most people are surprised by one part: the nasal packing that is sometimes placed afterwards to control bleeding. This page explains what to expect before, during and after.

Medically reviewed by Dr. Muralidhar Muddusetty, Surgical Oncologist, MBBS (AIIMS) · MS Surgery (AIIMS) · DNB Surg Onc · MRCS (Edinburgh) · Last reviewed September 2026

  • Done as day care — You do not need to be admitted to hospital. Most biopsies are done under local anaesthetic and you go home the same day.
  • Some bleeding is expected — A small amount of blood during and just after the procedure is normal. Heavy or prolonged bleeding needs to be reported.
  • Packing may be placed — If bleeding does not settle quickly, gauze or a sponge is placed inside the nostril. It is uncomfortable but temporary.
  • Results take time — The sample goes to a pathology laboratory. Results usually take several days to about two weeks.
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A nasal or sinus biopsy removes a small piece of tissue from inside the nose or sinus cavities to examine it under a microscope. It is done in an outpatient or day-care setting using local anaesthetic. Most people experience mild bleeding and some discomfort, not severe pain. Results take several days to about two weeks.

How is a nasal or sinus biopsy done?

The procedure is almost always done under local anaesthetic — a spray or an injection into the nasal lining. You are awake throughout and do not need a general anaesthetic in most cases.

Your surgeon uses a thin, lighted tube called an endoscope to see inside the nose or sinus. Small forceps or a punch instrument then removes one or more tiny pieces of tissue from the area of concern.

The sample is sealed and sent to a pathology laboratory. The procedure itself usually takes between fifteen and thirty minutes, depending on where the tissue needs to come from.

What happens step by step?

  1. Preparation

    You sit or recline slightly. A decongestant spray is applied first to reduce swelling inside the nose and help your surgeon see more clearly.

  2. Local anaesthetic applied

    Anaesthetic is sprayed or injected into the nasal lining. You may feel a brief sting, then numbness. The area will feel blocked or pressured, not painful.

  3. Endoscope placed

    A thin endoscope is gently passed into the nostril so your surgeon can see exactly where to take the sample.

  4. Tissue removed

    Small forceps pass alongside the endoscope. You will feel pressure and possibly a brief sharp sensation. The anaesthetic means this should not be strongly painful.

  5. Bleeding checked

    Your surgeon checks whether the site is bleeding. If it settles quickly, you are done. If not, packing or a cautery instrument is used.

  6. Recovery and discharge

    You rest in the clinic for a short period while staff monitor for bleeding. Once stable, you are discharged with written instructions.

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Is bleeding after a nasal biopsy normal?

Yes. The lining of the nose has a rich blood supply, and some bleeding during and just after the procedure is expected. It usually settles within a few hours.

Leaning forward and breathing through your mouth helps. Avoid blowing your nose on the day of the biopsy — this disturbs the clot forming at the biopsy site.

Call your team if bleeding is heavy rather than a trickle, does not settle after about half an hour of gentle pressure, or restarts significantly the following day.

What is nasal packing and does everyone need it?

Nasal packing is a small piece of gauze, foam or an inflatable balloon placed inside the nostril to apply steady pressure on the biopsy site. Your surgeon places it only if bleeding does not settle on its own — it is not used for every biopsy.

Packing is uncomfortable. The blocked nostril makes breathing feel difficult, and your voice may sound different while it is in place. This is not dangerous. Breathing through your mouth is the practical answer until it is removed.

If packing is placed, you are usually asked to return to clinic within one to two days for removal. Do not attempt to remove it yourself. Once it comes out, the discomfort clears quickly.

Did you know?

Cancers of the nasal cavity and sinuses are disproportionately linked to tobacco use — including smokeless products such as gutkha and khaini, which are widely used across Telangana and Andhra Pradesh.

If you use any tobacco product, telling your treating team is useful. They can connect you with support if you want it — there is no judgement in that conversation.

Source: ICMR, National Cancer Registry Programme

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Common questions

Frequently asked questions

Will the biopsy hurt?

You will feel pressure and possibly a brief sharp sensation when the tissue is taken, but local anaesthetic means it should not be strongly painful. The anaesthetic itself may sting for a few seconds. After the procedure, the area typically feels sore and bruised for a day or two. Over-the-counter pain relief is usually enough — ask your team what is safe to take alongside any other medication you are on.

How long will the whole appointment take?

Plan for two to three hours in total, even though the biopsy itself takes fifteen to thirty minutes. The remaining time covers preparation, waiting for the anaesthetic to work, post-procedure monitoring, and discharge instructions. If packing is placed, the monitoring period is a little longer before you are allowed to go home.

Can I drive myself home afterwards?

If only local anaesthetic was used and no sedation was given, you may be able to drive — but the safer plan is to arrange for someone to take you. Bleeding or discomfort in the first hour can be distracting, and some people feel lightheaded after the procedure. Check with your team when you confirm your appointment so you can plan ahead.

Do I need to stop blood thinners before the procedure?

Possibly. Medicines such as warfarin, aspirin, clopidogrel and certain newer anticoagulants affect how easily blood clots and can increase bleeding during and after the biopsy. Do not stop any of these without checking with your oncology team first — stopping them carries its own risks. Your team will advise whether to pause them and for how long, based on the specific medicine and the reason you are taking it.

When will I get the result?

The sample is processed by a pathology laboratory, which usually takes several days to about two weeks depending on the tests needed. Some analyses, such as immunohistochemistry, take longer than a basic histology report. Your oncologist will contact you to discuss the result at a follow-up appointment or by phone. Ask at discharge exactly how you will hear and what to do if you have not had a result within the expected window.

Can I smoke or use tobacco after the biopsy?

It is better not to, at least in the days immediately after the procedure. Smoke and tobacco irritate the healing nasal lining and can increase the risk of bleeding. If you use tobacco regularly, this is also a reasonable moment to mention it to your team — not because of any judgement about past use, but because stopping makes healing easier and reduces longer-term risk. They can refer you to cessation support if that would help.

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