Chronic rhinosinusitis with nasal polyps is a chronic respiratory disease. It is associated with local (nasal/sinus) and systemic (lower airway) inflammation and typically includes persistent symptoms of nasal congestion, rhinorrhea (runny nose), and loss of smell. These symptoms can have a significant impact on the patient’s quality of life.

Chronic rhinosinusitis is one of the most common medical conditions in the world. It is estimated to affect about 2% of the US population. About 20% to 30% of the patients with chronic rhinosinusitis have nasal polyps, which are noncancerous growths in the nasal cavities.

CRSwNP most frequently occurs in people during middle age, with peak incidence between the ages of 40 and 60 years. However, nasal symptoms develop slowly so many patients who are younger than this may have CRSwNP but do not seek medical care until later in the disease course.

While females are less likely to be affected than males, they are more likely to experience greater severity of symptoms.

The exact cause of CRSwNP is not fully understood. However, evaluation of nasal polyp tissue in patients has shown an elevated allergic type of cells called eosinophils. These cells can cause inflammation and the symptoms of CRSwNP. It is also possible that infection may be involved, particularly by Staphylococcus aureus bacteria.

The most common CRSwNP symptoms are:

  • Nasal congestion
  • Nasal drainage
  • Facial pressure or pain
  • Decrease or loss of smell

Of these, nasal congestion and loss of smell tend to be the most bothersome for patients.

CRSwNP is not contagious.

CRSwNP is often associated with several symptoms including nasal congestion and drainage, facial pressure/pain, and loss of smell. All these symptoms place a burden on patients. For example, many patients with an impaired sense of smell have difficulty tasting and enjoying food. There may also be psychological symptoms, including higher levels of depression, anxiety, and phobias.

However, several treatment options, including surgery and newer medications, can help control the disease. Educate yourself, communicate with your doctor, and learn about treatments to find the best regimen for you!

Sinus surgery for removal of polyps can be an option for patients if the polyps are troublesome and don’t respond to steroids or other medications. But even with surgery, polyps can come back, and long-term treatment is often needed.
CRSwNP is a long-term, chronic disease. Nasal polyps often come back despite surgery so long-term treatment is often necessary.

Several other medications have shown benefit for managing CRSwNP, including:

  • Leukotriene inhibitors (eg, montelukast)
  • Antibiotics (if infection is a concern)
  • Dupilumab (now approved for CRSwNP; also used to treat asthma and other inflammatory diseases)


  1. American Academy of Allergy, Asthma & Immunology (AAAAI). Nasal polyps. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/nasal-polyps
  2. Bachert C, Bhattacharyya N, Desrosiers M, et al. Burden of disease in chronic rhinosinusitis with nasal polyps. J Asthma Allergy. 2021;14:127-134.
  3. Claeys N, Teeling M, Legrand P, et al. Patients unmet needs in chronic rhinosinusitis with nasal polyps care: a Patient Advisory Board statement of EUFOREA. Front Allergy. 2021;2:761388.

Scientific Council

Neil M. Bressler, MD

James P. Gills Professor of Ophthalmology
Professor of Ophthalmology, Johns Hopkins University School of Medicine
Wilmer Eye Institute, Johns Hopkins Medicine
Baltimore, MD

A. Paul Chous, MA, OD, FAAO

Specializing in Diabetes Eye Care & Education, Chous Eye Care Associates
Adjunct Professor of Optometry, Western University of Health Sciences
AOA Representative, National Diabetes Education Program
Tacoma, WA

Steven Ferrucci, OD, FAAO

Chief of Optometry, Sepulveda VA Medical Center
Professor, Southern California College of Optometry at Marshall B. Ketchum University
Sepulveda, CA

Julia A. Haller, MD

Wills Eye Hospital
Philadelphia, PA

Allen C. Ho, MD, FACS

Director, Retina Research
Wills Eye Hospital
Professor and Chair of the Department of Ophthalmology
Thomas Jefferson University Hospitals
Philadelphia, PA

Charles C. Wykoff, MD, PhD

Director of Research, Retina Consultants of Houston
Associate Professor of Clinical Ophthalmology
Blanton Eye Institute & Houston Methodist Hospital
Houston, TX

Copyright © 2020 | CLEAR Initiative | All Rights Reserved | Website by Divigner

CLEAR Initiative

Chronic rhinosinusitis with nasal polyplosis (CRSwNP) is a chronic inflammatory disease of the nasal mucosa and paranasal sinuses that is associated with significant morbidity and reduced quality of life.

The pathophysiology of CRSwNP is associated with local and systemic inflammation, with ongoing symptoms of nasal congestion, rhinorrhea, and loss of smell. These symptoms result in a significant burden on patients.

As one of the most common medical conditions in the US, CRSwNP has a predominately type 2 inflammatory endotype. It is typically treated with medical management consisting of inhaled corticosteroids, oral corticosteroid bursts, and saline irrigation. Leukotriene antagonists and antibiotics are also used, and if medical management fails, surgical intervention is typically chosen. Additionally, biologics that target type 2 inflammation are now available. These have been or will be approved for use in these patients.

Our CLEAR program is an online tool that aims to provide clinicians and patients with up-to-date information on the presentation, prognosis, pathophysiology, and treatment strategies for individuals with CRSwNP. Our goal is to provide information that empowers clinicians and patients to speak openly about treatment decisions and improve the standard of care for patients with this challenging disease.

Thank you for visiting our website. We invite you to explore the Clinician Toolkit and Patient Toolkit links as well as our pages on CME events, a poster portal to create your own poster, links to animated videos, and much more!

This activity is provided by Med Learning Group. This activity is co-provided by Ultimate Medical Academy/Complete Conference Management (CCM).
This activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc. and Sanofi.

Copyright © 2019 | CLEAR Initiative | All Rights Reserved | Website by Divigner