This condition can impair breathing, smell, and overall quality of life. Proper treatment can help reduce inflammation in your sinuses and nasal passages, as well as decrease polyp size, to help ease symptoms.

Chronic rhinosinusitis is an extremely common condition that affects nearly 9% of adults worldwide. An estimated 20% of people with this condition also have nasal polyps.

Together, this is known as chronic rhinosinusitis with nasal polyps (CRwNP).

Learn more about the key characteristics of CRwNP and your treatment options.

CRwNP is a combination of two conditions:

  • Chronic rhinosinusitis: This is chronic nasal and sinus irritation and inflammation that persists for at least 12 weeks.
  • Nasal polyps: These are noncancerous (benign) soft tissue growths in your nose.

Both conditions may lead to long-term symptoms, such as:

  • congestion
  • nasal discharge
  • diminished or loss of smell
  • facial pain or pressure

The conditions can also occur together. Research suggests that about 20% of people with chronic rhinosinusitis have nasal polyps. You may be more likely to have both conditions if you have allergies or 20.

The average age of onset for CRwNP is 40 to 60 years. Over time, chronic rhinosinusitis increases your risk of developing nasal polyps. These growths can also worsen rhinosinusitis symptoms by blocking the typical flow of mucus, creating a mucus buildup that can further complicate the condition.

Nasal polyps refer to growths that line the nasal passageways. They sometimes grow into your sinuses.

Sinusitis is another term used for rhinosinusitis, or inflammation of the nasal passageways. It can be acute, when symptoms occur due to a common cold or bacterial infection and persist no longer than 4 weeks. Alternatively, it can become chronic if symptoms last for at least 12 weeks, even with treatment.

It can sometimes be hard to distinguish between nasal polyps and sinusitis, as they both cause the following symptoms:

  • sinus pressure
  • nasal congestion
  • nasal discharge
  • headache
  • tenderness around your forehead, nose, and cheeks
  • fatigue, usually caused by insomnia linked to nasal congestion

Plus, both conditions may occur together.

You may be able to tell that you have acute sinusitis if it’s linked to a bacterial, viral, or fungal infection. This can result in symptoms that aren’t directly caused by nasal polyps, such as:

  • yellow or green nasal discharge
  • pain in your teeth
  • bad breath
  • fever

Keep in mind that it’s possible to get a sinus infection in addition to nasal polyps.

If you’re experiencing unusual or chronic sinus symptoms, contact your doctor. They can make a diagnosis and guide you to the appropriate treatment.

Nasal polyps can cause a sinus infection by blocking how mucus flows between your sinuses and your throat.

This can cause mucus to become trapped in your sinuses, which allows germs to grow and an infection to develop.

Your doctor can diagnose nasal polyps through testing, which may include:

  • a nasal endoscopy
  • imaging tests like a CT scan
  • allergy and immune testing

They may also recommend a full medical workup to look for other health conditions that often occur with nasal polyps.

Treatment for CRwNP focuses on decreasing inflammation in your sinuses and nasal passages to reduce symptoms. Some treatments can help shrink nasal polyps to prevent further obstruction of your nasal cavity.

Ask your doctor about the following treatment options:

  • Nasal steroid sprays: These target both chronic rhinosinusitis and polyps, and they’re considered safe to use in the long term.
  • Oral steroids: Your doctor may prescribe these periodically to treat severe inflammation in your sinuses and nasal passages. Due to the risk of side effects, oral steroids are taken only in the short term.
  • Over-the-counter (OTC) nasal sprays: Certain allergy nasal sprays, such as fluticasone (Flonase, Xhance), may help reduce inflammation and improve symptoms such as congestion and a runny nose. Be sure to ask your doctor before using an OTC formula if you’re already taking a prescription nasal spray. Your doctor may also recommend regularly using a saline nasal spray to rinse your nasal passages.
  • Antibiotics: If your doctor diagnoses you with a bacterial sinus infection, you may be prescribed a course of antibiotics. These will help treat some of the symptoms of acute sinusitis but won’t have any effect on nasal polyps.

If you have chronic CRwNP that doesn’t respond to standard steroid therapies, your doctor may recommend:

  • Biologics: Your doctor may recommend injectable biologic drugs, such as dupilumab (Dupixent), mepolizumab (Nucala), or omalizumab (Xolair) to treat CRwNP. They work by lowering inflammation in the nasal passages to reduce symptoms.
  • Surgery: If medications aren’t enough to manage CRwNP, especially if you have multiple, large polyps, your doctor may recommend a polypectomy, which is a type of surgery to remove these growths. While nasal polyp surgery can relieve symptoms, it’s possible for polyps to grow back. You may also still need to take medications to help manage nasal and sinus inflammation.
  • Drug-eluting stents: These devices can be inserted into the sinuses after surgery. They work by slowly releasing steroid medication into the nasal passages to help lower inflammation and reduce the need for future surgery or steroid use.

Chronic rhinosinusitis with nasal polyps (CRwNP) is a combination of nasal and sinus inflammation with benign growths in your nasal passages, called polyps. Over time, these growths can become larger and worsen rhinosinusitis symptoms.

If you’re having difficulties with long-term nasal congestion or other sinus-related symptoms despite taking medications, it’s important to have a doctor examine your sinuses. Numerous treatments can help reduce or eliminate polyps and manage CRwNP symptoms.