Ep. 149: What is Chronic Rhinosinusitis without Nasal Polyps
Part of the series: Allergy, Asthma & Immunology Innovations Podcast
This podcast was made in partnership with Allergy & Asthma Network.
We thank Insmed for sponsoring this episode. While they support the show, all opinions are our own, and sponsorship doesn’t influence our content or editorial decisions. Any mention of brands is for informational purposes and not an endorsement.
Chronic sinusitis without nasal polyps is the most common form of chronic sinusitis. Even so, most patients spend years without a clear explanation, cycling through antibiotics that do not address what is actually going on.
In this episode, Kortney and Dr. Payel Gupta are joined by Dr. Michael Blaiss and Dr. Anju Peters, an allergist and immunologist at Northwestern University who co-authored the 2025 Adult Sinusitis Clinical Practice Guideline. Together, they break down what chronic sinusitis without nasal polyps (CRSsNP) actually is, what the real quality-of-life impact looks like, and how a proper diagnosis is confirmed.
What we cover in our episode aboutwhat chronic hives control looks like:
Not an infection. Chronic sinusitis without nasal polyps is driven by inflammation lasting 12 weeks or more, not by bacteria or a virus, which is why antibiotics often do not help.
The hidden quality of life burden. Beyond congestion and sinus pressure, patients commonly experience fatigue, poor sleep, anxiety, depression, and social isolation.
Why so many patients go years without a correct diagnosis. Symptoms overlap significantly with conditions like allergic rhinitis or migraines. Many patients adapt to feeling unwell rather than seeking answers.
How doctors confirm the diagnosis. A diagnosis requires objective evidence of inflammation, as seen on nasal endoscopy or a CT scan of the sinuses, not symptoms alone.
The connection between sinusitis and asthma. The nose, sinuses, and lungs share one connected airway, and about 60% of people with this condition also have asthma, with each capable of making the other worse.
About our guest
Dr. Anju Peters is a board-certified allergist and immunologist at Northwestern University in Chicago, Illinois, where she specializes in chronic rhinosinusitis and its relationship to asthma and other airway conditions. Dr. Peters co-authored the 2025 Adult Sinusitis Clinical Practice Guideline and leads a multidisciplinary sinus center where patients receive integrated care from allergy and rhinology specialists
More resources about chronic hives
2025 Adult Sinusitis Clinical Practice Guideline
Sinusitis resources from Allergy and Asthma Network
Episodes about chronic rhinosinusitis with nasal polyps (CRSwNP)
Timestamps
Our episode unpacks the nuances involved with chronic rhinosinusitis
01:37 Dr. Peters introduction
03:46 What CRSsNP is and how it differs from a sinus infection
05:46 What causes CRSsNP
09:01 How CRSsNP is diagnosed
15:07 Discolored mucus
16:27 How to distinguish CRS from other conditions
18:11 Why antibiotics are often not the answer
19:49 Immune deficiency and CRSsNP
22:49 The united airway: sinusitis and asthma
25:05 Environment and occupational triggers
27:33 Takeaways for patients
