Chronic rhinosinusitis is an extremely common condition that affects about 12 percent of adults worldwide. An estimated 20 percent of people with this condition also have nasal polyps.

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

The average age of onset for CRwNP is 40 to 60 years old, according to a 2016 research review. A 2015 review notes that people with this condition are also more likely to have a history of allergies and asthma. Gastroesophageal reflux disease (GERD) may also be a risk factor.

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 often occur together and can make each other worse.

Over time, chronic rhinosinusitis increases your risk of developing nasal polyps. These growths can also worsen rhinosinusitis symptoms by blocking normal mucus flow.

Research suggests that about 20 percent of people with chronic rhinosinusitis have nasal polyps. You may be more likely to have both conditions if you have allergies or asthma.

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.

Acute sinusitis often occurs when a common cold develops into a bacterial infection. Symptoms last for less than 4 weeks.

Your doctor may diagnose you with chronic rhinosinusitis if your symptoms last for at least 12 weeks even with treatment.

Nasal polyps and chronic sinusitis frequently occur together. It’s also possible to have each condition separately.

It can sometimes be hard to distinguish between the conditions. Both sinusitis and nasal polyps can 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

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 having unusual or chronic sinus symptoms, contact your doctor. They can make a diagnosis and guide you to the appropriate treatment as necessary.

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 can lead to infection.

Your doctor will 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 is focused on decreasing inflammation in your sinuses and nasal passages to reduce your 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. Oral steroids are taken only in the short term, due to the risk of side effects.
  • Over-the-counter (OTC) nasal sprays. Certain allergy nasal sprays — including fluticasone (Flonase, Xhance) — may help reduce inflammation and improve symptoms such as congestion and runny nose. Be sure to ask your doctor before using an OTC formula if you’re already taking a prescription nasal spray. Doctors 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 a severe case of CRwNP that doesn’t respond to standard steroid therapies, talk with your doctor about:

  • Leukotriene modifiers. A 2013 review suggests these medications may reduce CRwNP symptoms and polyp size. The allergy medication montelukast in particular may help people who have CRwNP along with asthma.
  • Biologics. Dupilumab (Dupixent) and omalizumab (Xolair) are two other allergy and asthma medications approved by the Food and Drug Administration (FDA) to treat CRwNP. According to a 2020 review, studies suggest that dupilumab reduces polyp size, alleviates nasal congestion, and reduces the need for surgery. Other 2020 research has found that omalizumab significantly improves symptoms and quality of life compared with a placebo.

In some cases, medications aren’t enough to manage more severe CRwNP, especially if you have many polyps that are larger in size. At this point, your doctor may recommend a polypectomy, which is a type of surgery to remove these growths.

While nasal polyp surgery can provide relief from your symptoms, it’s possible for polyps to grow back. And you may still need to take medications to help manage nasal and sinus inflammation often linked to triggers like allergies.

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 struggling 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.