Ep. 167: How Is Chronic Rhinosinusitis Without Nasal Polyps Diagnosed and Treated?
Part of the series: Allergy, Asthma & Immunology Innovations Podcast
This podcast was made in partnership with Allergy & Asthma Network.
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Chronic rhinosinusitis without nasal polyps (CRSsNP) is the type that makes up most chronic sinusitis cases. It's often mistaken for allergies, a lingering cold, or migraines, which can delay a proper diagnosis for years.
Dr. Gupta and Kortney sit down with Dr. Anju Peters, an allergist at Northwestern University's Feinberg School of Medicine, to unpack how this condition is actually diagnosed, why it can take patients years to get an answer, and which treatments have real evidence behind them.
What we cover in our episode about chronic rhinosinusitis without nasal polyps
Two types of chronic sinusitis. About 75% of chronic sinusitis patients do not have nasal polyps, and about 20 to 25% do, and the treatment path differs depending on which type you have.
Getting the right diagnosis. Doctors confirm chronic sinusitis without nasal polyps by combining at least 12 weeks of symptoms with objective proof of inflammation.
Ruling out look-alikes. Allergies, colds, and migraines can all cause similar congestion and pressure, so doctors pay close attention to how long symptoms last and whether inflammation is actually confirmed.
Building a treatment toolkit. Nasal steroid sprays are the backbone of treatment.
When to consider surgery. When sinus surgery becomes the next step in sinus care.
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 CRSsNP
Allergy & Asthma Network: chronic rhinosinusitis overview
Treatment and management of chronic rhinosinusitis
How to use the FDA-approved nasal spray
Timestamps
Our episode about treating and diagnosing chronic rhinosinusitis
01:55 Difference between CRS with and without polyps
03:30 How is CRSsNP diagnosed
05:35 The journey of being diagnosed
09:10 CT scan or endoscopy for diagnosis
10:45 Why it's so important to rule out polyps
11:48 Treatment options for CRSsNP
15:51 Decongestant sprays, antibiotics, and allergy meds
18:15 Intranasal antihistamines
20:35 Ipratropium bromide nasal spray
22:48 Antibiotics and oral steroids
24:12 When to turn to surgery
25:21 Allergy immunotherapy and immunodeficiency
26:48 What treatments are in the pipeline
