To introduce and describe this newly recognized variant of CRS, termed CCAD.

A case series of 15 patients from two institutions presented with sinonasal symptoms and demonstrated central compartment polypoid mucosal changes on CT. The endoscopic appearance of central compartment edema was assessed. Allergy status was determined by skin or serum in vitro testing.

The mean ± standard deviation patient age was 42.4 ± 14.8 years, and 47% were women. All 15 patients diagnosed allergic rhinitis symptomatically, and those who underwent allergy assessment tested positive. All the patients had central compartment polypoid edema on endoscopy and central nasal soft-tissue thickening with peripheral clearing on CT. Even with more severe sinus disease, a central focus of inflammatory change existed.

The present study concluded that CCAD might represent a local inhalant allergy process that affects ethmoid origin’s central nasal structures. Although inhalant allergy changes mainly appear within the nasal cavity, medial-to-lateral progression involving sinuses can occur as a simple obstructive phenomenon. This is a CRS pattern distinct from the more diffuse sinonasal inflammatory disease and likely requires allergy management as a core component.

Reference: https://journals.sagepub.com/doi/full/10.2500/ajra.2017.31.4443