Chronic rhinosinusitis (CRS) is a condition that causes inflammation and swelling in the sinuses, which are the air-filled spaces in your skull.1 This inflammation can last for 12 weeks or more, leading to a variety of bothersome symptoms.7
There are two main types of CRS:
- Chronic rhinosinusitis with nasal polyps (CRSwNP): This type is characterized by the presence of nasal polyps, which are soft, noncancerous growths that develop in the lining of the nasal passages or sinuses.8
- Chronic rhinosinusitis without nasal polyps (CRSsNP): This type occurs when there are no nasal polyps present.3
What Are The Symptoms?7
Both CRSwNP and CRSsNP can cause a range of symptoms, including:
- Nasal congestion or stuffiness
- Runny nose
- Facial pain or pressure
- Loss of smell
- Postnasal drip (mucus dripping down the back of the throat)
In addition to these common symptoms, CRSwNP can also cause:
- Decreased sense of taste
- Snoring2
- Headaches
- Pain in the upper teeth
What Causes These Conditions?
The exact causes of CRSwNP and CRSsNP are not fully understood, but several factors are thought to contribute, including:
- Infections: Bacterial, viral, or fungal infections can trigger inflammation in the sinuses.
- Allergies: Allergies to pollen, dust mites, mold, or pet dander can irritate the nasal passages and sinuses.
- Structural problems: Deviated septum or other structural issues in the nose can obstruct airflow and increase the risk of sinus infections.
- Underlying medical conditions: Conditions like asthma, cystic fibrosis, and aspirin sensitivity can make people more likely to develop CRS.
How Are They Diagnosed?
A doctor will typically diagnose CRSwNP or CRSsNP based on your symptoms, a physical exam, and sometimes additional tests, such as:
- Nasal endoscopy: A thin, flexible tube with a camera is inserted into the nasal passages to visualize the lining and identify any polyps or other abnormalities.
- CT scan: This imaging test provides detailed pictures of the sinuses and can help identify blockages or other structural issues.
How Are They Treated?
The treatment for CRSwNP and CRSsNP will depend on the severity of your symptoms and the underlying cause. Common treatment options include:
- Nasal corticosteroids: These sprays or rinses help reduce inflammation in the nasal passages and sinuses.
- Saline nasal rinses: These rinses help clear mucus and irritants from the nasal passages.
- Oral medications: In some cases, oral corticosteroids or antibiotics may be prescribed to treat more severe inflammation or infection.
- Surgery: In rare cases, surgery may be recommended to remove nasal polyps or correct structural problems in the nose or sinuses.
Living with CRSwNP or CRSsNP
If you are diagnosed with CRSwNP or CRSsNP, there are several things you can do to manage your symptoms and improve your quality of life:2
- Follow your doctor’s treatment plan: Take your medications as prescribed and keep your follow-up appointments.
- Practice good nasal hygiene: Use saline nasal rinses regularly to keep your nasal passages clean.
- Avoid triggers: Identify and avoid things that irritate your nasal passages, such as allergens, smoke, and strong odors.
- Manage underlying conditions: If you have asthma or other medical conditions that contribute to your CRS, work with your doctor to manage those conditions effectively.
References
- Bose S, Grammer LC, Peters AT. Infectious Chronic Rhinosinusitis. J Allergy Clin Immunol Pract. 2016 Jul-Aug;4(4):584-9. doi: 10.1016/j.jaip.2016.04.008. PMID: 27393772; PMCID: PMC4939240.
- “Chronic Rhinosinusitis with Nasal Polyps.” ACAAI Public Website, 27 July 2021, acaai.org/allergies/allergic-conditions/chronic-rhinosinusitis-with-nasal-polyps/.
- Darougar S, Hematyar M, Savoji PB. A mini-update on chronic rhinosinusitis. Explor Asthma Allergy. 2024;2:473–84. https://doi.org/10.37349/eaa.2024.00059
- Mayo Clinic. “Chronic Sinusitis – Symptoms and Causes.” Mayo Clinic, 2019, www.mayoclinic.org/diseases-conditions/chronic-sinusitis/symptoms-causes/syc-20351661.
- NHS. “Steroid Nasal Sprays.” Nhs.uk, 18 Oct. 2017, www.nhs.uk/conditions/steroid-nasal-sprays/.
- Penn Medicine. “Sinus Infections (Sinusitis).” Pennmedicine.org, 2022, www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/sinus-infections-sinusitis.
- “Sinus Infection (Sinusitis or Rhinosinusitis).” Yale Medicine, www.yalemedicine.org/conditions/sinus-infection-sinusitis-or-rhinosinusitis.
- Stevens WW, Schleimer RP, Kern RC. Chronic Rhinosinusitis with Nasal Polyps. J Allergy Clin Immunol Pract. 2016 Jul-Aug;4(4):565-72. doi: 10.1016/j.jaip.2016.04.012. PMID: 27393770; PMCID: PMC4939220.
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