Sinus411.org

The web site for people with sinus problems

Chronic sinusitis without polyps is a condition of inflammation of the sinuses which lasts more than 12 weeks, and when examined by doctors, there is no evidence of polyps in the nose or sinuses.  

Whether there are polyps or no polyps turns out to be an important distinction or important classification, because usually the treatments are different when there are polyps versus when there are no polyps.   Also, patients with polyps often have other issues such as allergies or asthma.  We’ll discuss these treatment more later.   Now, the goal is just to broadly classify the different types of sinusitis, to give you a sense of the big picture, and perhaps (for those with limited time) to allow you to skip to a section which may be of more interest to you. 

There is still inflammation of the mucosa in most or all patients with chronic sinusitis without polyps, but the inflammation does not trigger the growth of polyps.  The inflammation often looks quite different if there are no polyps, especially when a pathologist looks at the tissue under the microscope.  Also, patients with chronic sinusitis without polyps are more likely to have “infection” causing the “itis”, that is infection causing the inflamed tissues.   In contrast, patients with polyps may have inflammation of the nasal and sinus tissues due to some “intrinsic” problem with their immune  system (or some problem that we’ve called intrinsic because we don’t understand it yet). 

So, when a specialist sees a patient with chronic sinusitis without polyps, he or she will be looking with a bit more suspicion for a bacterial infection, a viral infection, some types of fungal infections, or other unusual causes of sinusitis.   More on that later.