#137 - Diagnosing Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)

Persistent congestion, pressure, or a reduced sense of smell often gets mistaken for allergies or a stubborn cold when it may be something more, like chronic rhinosinusitis with nasal polyps (CRSwNP). Getting the right diagnosis is the first step toward real relief. Dr. Tonya Farmer, a board-certified ENT, joins Kortney and Dr. G to explain how chronic rhinosinusitis with nasal polyps (CRSwNP) is diagnosed. She walks us through the full evaluation: what symptoms matter, what a nasal endoscopy actually shows, when a CT scan is needed, and how type 2 inflammation fits into the picture. What we cover about diagnosing CRSwNP: Key symptoms: Persistent congestion, drainage, facial pressure, and especially loss of smell are major red flags for CRSwNP. Why duration matters: Chronic means 12 weeks or longer. If symptoms keep coming back or never truly improve, it’s time to look deeper. The physical exam: ENTs use nasal endoscopy to see swelling, mucus, or polyps that aren’t visible from the outside. When CT scans are needed: Imaging helps confirm sinus inflammation and shows the extent of polyp growth. Additional testing: Allergy testing, IgE levels, eosinophils, and other immune markers help identify type 2 inflammation and guide next steps. When to see a specialist: If antibiotics, steroids, or over-the-counter treatments aren’t helping, ask for a referral to an allergist or ENT. Early diagnosis can prevent worsening symptoms and reduce the need for surgery. Set the foundations: Ep. 133: What is Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)? ___   Made in partnership with The Allergy & Asthma Network. Thanks to Sanofi-Regeneron for sponsoring today’s episode.  This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.