How Is Chronic Rinosinusitis without Nasal Polyps Diagnosed and Treated?

Welcome to the latest episode of the Allergy, Asthma and Immunology Innovations podcast. Our latest episode looks at diagnosing and treating chronic rhinosinusitis without nasal polyps (CRSsNP). CRSsNP is the most common type of chronic sinusitis, but it is often mixed up with allergies, a cold that will not go away, or migraines.

Co-hosts Payel Gupta, MD, a board-certified allergist and immunologist, and Kortney, a patient advocate, talk with Anju Peters, MD, an allergist at Northwestern University. Together they discuss how doctors diagnose this condition and what treatments are available.

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Thank you to Insmed for sponsoring this episode.

Key Takeaways About Chronic Rhinosinusitis without Nasal Polyps

Chronic sinusitis without nasal polyps can be hard to spot. It shares symptoms with allergies, colds, and migraines. But doctors have clear steps to find it and treat it.

  • Two types of chronic sinusitis. Most people with chronic sinusitis do not have polyps. Treatment is different depending on which type you have.
  • How doctors diagnose it. Symptoms must last 12 weeks or more. Doctors also need to see swelling, either on a CT scan or through an endoscopy (a camera that goes in the nose).
  • Why it can be missed at first. Allergies, colds, and migraines can look similar. Doctors check how long symptoms last to help tell them apart.
  • Nasal treatments that help. Steroid nasal sprays are the main treatment. Some patients also use antihistamine sprays, short-term decongestant sprays, or XHANCE, an FDA-approved device.
  • When to consider surgery. If nasal sprays and rinses are not enough, surgery can help open up blocked areas, so treatments work better.

Episode Timestamps From our Podcast on Chronic Rhinosinusitis without Nasal Polyps

01:55 – CRS with vs. without polyps

03:30 – Diagnosing CRSsNP

05:35 – The diagnosis journey

09:10 – CT scan or endoscopy

10:45 – Why ruling out polyps matters

11:48 – Treatment options

15:51 – Decongestants, antibiotics, allergy meds

18:15 – Intranasal antihistamines

20:35 – Ipratropium bromide spray

22:48 – Antibiotics and oral steroids

24:12 – When to consider surgery

25:21 – Immunotherapy and immunodeficiency

26:48 – What’s next in treatment?

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