Podcast Host: Scott Fortune, MD, FAAOA Podcast Guests: Meha Fox, MD, FAAOA; Peter Filip, MD, FAAOA

If you’ve trained in the last decade, you probably learned to classify chronic rhinosinusitis as one of two things: CRS with nasal polyps or CRS without nasal polyps. That’s CRSwNP and CRSsNP. Simple. Clean. Easy to document.

But here’s the problem — that binary has been quietly failing us for years. It doesn’t tell us why a patient has polyps. It doesn’t predict who will respond to biologics. And it doesn’t explain why two patients with identical CT scans can have completely different disease trajectories.

EPOS 2020 — the European Position Paper on Rhinosinusitis and Nasal Polyps — rewired how we should think about this disease. Today we’re going to walk through their classification framework, explain the biological logic behind it, and talk about what this means for how you actually manage patients in your clinic.

Listen to this podcast to learn more.

Key References:

Fokkens WJ, et al. EPOS 2020: European Position Paper on Rhinosinusitis and NasalPolyps 2020. Rhinology. 2020;58(Suppl S29):1-464.

Additional Suggested Reading:

Laidlaw TM, Mullol J, et al. Biologics for CRSwNP and AERD. J Allergy Clin Immunol Pract. 2021.Soler ZM, et al. Eosinophilic CRS across the United States. Am J Rhinol Allergy. 2022.Stevens WW, et al. Central Compartment Atopic Disease. Am J Rhinol Allergy. 2015.Mullol J, Han JK, Laidlaw TM, Hopkins C, Peters AT, Pfaar O, Desrosiers M, Lee SE, Lane AP, Chen C, Chon Y, Ponnarambil SS, Foster A, Lindsley AW, Ambrose CS. Early and Sustained Improvements in Sense of Smell With Tezepelumab Treatment in Patients With Chronic Rhinosinusitis With Nasal Polyps (WAYPOINT). Int Forum Allergy Rhinol. 2026 May;16(5):484-494. doi: 10.1002/alr.70090. Epub 2026 Jan 6. PMID: 41493192; PMCID: PMC13147228.

Key Terms Defined in Episode:

CRS — Chronic RhinosinusitisCRSwNP—Chronic Rhinosinusitis with Nasal PolypsCRSsNP—Chronic Rhinosinusitis without Nasal PolypsEPOS — European Position Paper on Rhinosinusitis and Nasal PolypsAFRS — Allergic Fungal RhinosinusitisCCAD — Central Compartment Atopic DiseaseeCRS — Eosinophilic CRSType 2 inflammation — Th2/ILC2-mediated, IL-4/IL-5/IL-13 cytokine signature, eosinophil-dominantNon-eCRS — Non-eosinophilic CRS, includes neutrophilic and other endotypesDupilumab — IL-4Rα antagonist (Dupixent); FDA approved for CRSwNPMepolizumab / Benralizumab — Anti-IL-5 biologics

For more: www.AAOAllergy.org

Watch the YouTube version of the podcast here.

Are you missing rare eosinophilic disease diagnoses? Join an expert multidisciplinary panel for a podcast series highlighting the diagnostic challenges of eosinophilic granulomatosis with polyangiitis (EGPA; formerly Churg-Strauss) and what the otolaryngologist needs to know. Moderated by Dr. Jennifer Villwock.

Rare Eosinophilic Disease Part 2 – Diagnostic Challenges & the Role of the ENT

Listen to 2 expert otolaryngologists, Drs. Michael Platt and Ashoke Khanwalkar, in conjunction with their pulmonologist (Dr. Praveen Akuthota) and rheumatologist (Dr. Anisha Dua) colleagues, review the nuances of the ENT presentation in patients with EGPA including diagnostic tests, the role of biopsy and tips around referrals. Listen to Part 1

This is a non-CME disease state educational podcast series brought to you by the AAOA and sponsored by GSK. The information presented is scientific and non-promotional in nature. The panelists are practicing physicians paid by GSK to share their knowledge and expertise.

Trademarks are owned by or licensed to the GSK group of companies.©2024 GSK group of companies or its licensor.

Listen to Drs. Praveen Akuthota (pulmonologist), Anisha Dua (rheumatologist), and Michael Platt (otolaryngologist) provide an overview of EGPA and highlight what findings

might increase the level of suspicion for rare disease.

In the fourth and final episode of CRS with/without Nasal Polyps Podcast Series: Shared Decision-Making, Jennifer Villwock, MD will bring together the 3 speakers from the previous 3 podcasts in this series to discuss their approaches to shared decision-making with patients diagnosed with chronic rhinosinusitis with/without nasal polyps as well as their thoughts about how to incorporate multidisciplinary/co-specialty management into their respective practices to optimize patient care.  

Please take a short feedback survey: https://forms.gle/wFABuP8JXWUhPDwQ8 or email [email protected].

In the third episode of CRS with/without Nasal Polyps Podcast Series: Quality of Life Burden,  Jennifer Villwock, MD will be speaking with Christine Franzese, MD about the potential quality of life burdens experienced by patients with chronic rhinosinusitis with/without nasal polyps, how this may impact course of disease and optimal ways to address these issues with patients.  Dr. Villwock is an associate professor, Otolaryngology-Head and Neck Surgery at Kansas University Medical Center and Chief of Otolaryngology, Kansas City Veterans Affairs Hospital. Dr. Franzese is Professor of Clinical Otolaryngology and Medical Student Director at the University of Missouri in Columbia, MO.

Please take a short feedback survey: https://forms.gle/wFABuP8JXWUhPDwQ8 or email [email protected].

Christine Franzese, MDColumbia, MO

Christine Franzese, MD is a general otolaryngologist, with a specialty focus on Allergy and Sinus Diseases, and Professor in the Department of Otolaryngology at University of Missouri Medical Center.  She is a native of Watkins Glen, NY and received her undergraduate degree from Cornell University in Ithaca, NY. She received her M.D. from SUNY Upstate Medical Center and completed her residency training at Penn State Milton S. Hershey Medical Center and the University of Mississippi Medical Center. She stayed on as faculty at the University of Mississippi Medical Center for eight years where she was Residency Program Director, as well as Associate Professor and Chief of Otolaryngology at the G.V. “Sonny” Montgomery V.A. Medical Center. 

She is a former Past President of the American Academy of Otolaryngic Allergy [AAOA]. Prior to that, she was President, President-Elect, and Treasurer of the AAOA, and Chair for the Section of Women in Otolaryngology in the American Academy of Otolaryngology-Head and Neck Surgery [AAO-HNS]. She has also served on the AAO-HNS Annual Program Committee and as Consultant to the AAO-HNS Allergy and Immunology Committee. She has taught at many allergy courses, including the AAOA Basic Allergy and Immunology Course, the AAOA Advanced Allergy and Immunology Course, and was co-Course Director for the AAOA Interactive Allergy & Rhinology Course. She has served as the first Chair of the SUO-Otolaryngology Program Directors Organization, as a member of the AAO-HNS Rhinology and Paranasal Sinuses Committee, and as a Member-at-Large on the AAOA Board of Directors. She has authored many scientific papers and is Chief Editor and one of the authors of “The Handbook of Otolaryngic Allergy” published in 2019. She has a special focus on biologics and treating allergic disorders, including inhalant allergy, penicillin allergy, allergies to stinging insects, food allergy, asthma, atopic dermatitis and urticaria.

Jennifer Villwock, MD, FAAOAKansas City, KS 

Dr. Jennifer Villwock is a board-certified otolaryngologist and fellow of the AAOA. She attended medical school at the Michigan State University – College of Human Medicine and residency at SUNY-Upstate in Syracuse, NY. Dr. Villwock is currently an associate professor and associate residency program director at the University of Kansas Medical Center. Her academic interests include olfaction and sinonasal disease. She is also passionate about medical education from the undergraduate level to continuing education. Dr. Villwock’s outside interests include “gardening” aka (according to her husband) digging up perfectly good lawn and then neglecting what she plants there instead.

In the second episode of CRS with/without Nasal Polyps Podcast Series: Common Co-morbidities, Jennifer Villwock, MD will be speaking with Amber Luong, MD, PhD, about recognition of the respiratory and non-respiratory co-morbidities often associated with chronic rhinosinusitis with/without nasal polyps and how this might influence diagnosis and disease outcomes. Dr. Villwock is an associate professor, Otolaryngology-Head and Neck Surgery at Kansas University Medical Center and Chief of Otolaryngology, Kansas City Veterans Affairs Hospital.  Dr. Luong is Professor and Vice Chair for Research, Department of Otorhinolaryngology, McGovern Medical School, University of Texas Health Science Center in Houston, Texas.

Please take a short feedback survey: https://forms.gle/wFABuP8JXWUhPDwQ8 or email [email protected].

Amber Luong, MD, PhDHouston, TX

Amber Luong, MD, PhD, serves as a Professor and Vice Chair for Research in the Department of Otorhinolaryngology at the McGovern Medical School of the University of Texas Health Science Center at Houston with a joint appointment within the Center of Immunology and Autoimmune Diseases at the Institute of Molecular Medicine. She currently serves on the Board of Directors for the American Rhinologic Society and inaugural chair of Allergy and Immunology in Rhinology section. Dr. Luong obtained her MD/PhD at the University of Texas Southwestern Medical Center at Dallas through the NIH sponsored Medical Scientist Training Program. She obtained her Ph.D. under the Nobel laureates Drs. Michael Brown and Joseph Goldstein for the identification and biochemical characterization of a novel human enzyme, acetyl coA synthetase. She then completed her residency training at UT Southwestern and rhinology fellowship training at the Cleveland Clinic. Dr. Luong has co-authored over 90 peer-reviewed articles and book chapters. She is a 2020 Executive Leadership in Academic Medicine (ELAM), recipient of the 2017 Women in Otolaryngology Helen F. Krause, MD Memorial Trailblazer Award and the 2017 Women Faculty Forum Excellence Award. Her primary research interest focuses on understanding the role of the innate immune response in the pathophysiology of chronic rhinosinusitis, with a particular interest in the role of environmental fungi in initiating these innate immune responses. She is the recipient of the 2019 Edmund Prince Fowler Award for best basic science research thesis from the Triological Society. She has received external funding from the NIH, American Academy of Otolaryngic Allergy, The Triological Society, and is actively involved in several industry-sponsored multicenter clinical trials. Dr. Luong’s clinical interest parallels her research interest in allergic fungal rhinosinusitis as well as the medical and surgical management of refractory chronic rhinosinusitis, sinonasal tumors, CSF leak repairs, and endoscopic orbital and dacryocystorhinostomy surgery.

Jennifer Villwock, MD, FAAOAKansas City, KS 

Dr. Jennifer Villwock is a board-certified otolaryngologist and fellow of the AAOA. She attended medical school at the Michigan State University – College of Human Medicine and residency at SUNY-Upstate in Syracuse, NY. Dr. Villwock is currently an associate professor and associate residency program director at the University of Kansas Medical Center. Her academic interests include olfaction and sinonasal disease. She is also passionate about medical education from the undergraduate level to continuing education. Dr. Villwock’s outside interests include “gardening” aka (according to her husband) digging up perfectly good lawn and then neglecting what she plants there instead.

In the first episode of CRS with/without Nasal Polyps Podcast Series: From Immune Pathways to Clinical Practice, Jennifer Villwock, MD will be speaking with Joshua Levy, MD, MPH about how to better understand immune pathways associated with chronic rhinosinusitis with/without nasal polyps and how this might influence diagnosis, disease presentation and course of disease. Dr. Villwock is an Associate Professor, Otolaryngology-Head and Neck Surgery at Kansas University Medical Center and Chief of Otolaryngology, Kansas City Veterans Affairs Hospital. Dr. Levy is Associate Professor of Otolaryngology and Director of Resident research in the Emory Department of Otolaryngology, Emory School of Medicine in Atlanta, Georgia.

Please take a short feedback survey: https://forms.gle/wFABuP8JXWUhPDwQ8 or email [email protected].

Joshua M. Levy, MD, MPHAtlanta, GA

Dr. Levy is a board-certified otolaryngologist who practices in an academic setting at Emory University School of Medicine in Atlanta, GA. He is originally from Maryland and went to Cornell University for his undergraduate degree. He completed his medical and public health education at Tulane University in New Orleans, LA, where he also completed his residency in otolaryngology-head and neck surgery. He then completed a fellowship in rhinology at Oregon Health & Science University. He is an assistant professor of otolaryngology and director of resident research at Emory. His research is supported by several industry, foundation and NIH awards, and involves exploration of biologics for allergic fungal rhinosinusitis, as well as the role of endogenous cannabinoids in aspirin-exacerbated respiratory disease. Josh lives in the Atlanta area with his wife and daughter Margot.  

Jennifer Villwock, MD, FAAOAKansas City, KS 

Dr. Jennifer Villwock is a board-certified otolaryngologist and fellow of the AAOA. She attended medical school at the Michigan State University – College of Human Medicine and residency at SUNY-Upstate in Syracuse, NY. Dr. Villwock is currently an associate professor and associate residency program director at the University of Kansas Medical Center. Her academic interests include olfaction and sinonasal disease. She is also passionate about medical education from the undergraduate level to continuing education. Dr. Villwock’s outside interests include “gardening” aka (according to her husband) digging up perfectly good lawn and then neglecting what she plants there instead.

In the third episode of the AAOA’s NEW podcast series Today in ENT Allergy: AAOA’s Podcast, Jennifer Villwock, MD, FAAOA speaks with Gavin Setzen, MD, FAAOA. They are discussing the integral role allergy plays in ENT practice. How and why one might consider adding allergy to her/his ENT practice. Dr. Setzen shares his experience and expertise.

Dr. Gavin Setzen received his medical degree from the University of Witwatersrand Medical School in Johannesburg, South Africa. He was a general surgery resident at North Shore University Hospital, Cornell University Medical College in New York, NY, before completing an Otolaryngology residency at Albany Medical Center in Albany, NY. Dr. Setzen is currently in private practice in Albany, NY. He is the Past President of the American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS). Other notable positions include Clinical Associate Professor of Otolaryngology – Head and Neck Surgery at Albany Medical College and Chief of the Otolaryngology Division at St. Peter’s Hospital in Albany, NY. He is an active member and Fellow of several organizations, including the AAO-HNS, American College of Surgeons (ACS), the American Rhinologic Society, the American Academy of Otolaryngic Allergy, and the American Head and Neck Society. He has published numerous peer-reviewed articles, book chapters and has delivered scientific lectures and presentations at national and international meetings.

Note: The views, information, or opinions expressed during the AAOA podcast series are solely those of the individuals involved and do not necessarily represent those of The American Academy of Otolaryngic Allergy (AAOA) or its employees or members.  The AAOA is not responsible and does not verify for accuracy any of the information contained in and assumes no liability for any activities in connection with this podcast series. The primary purpose of this podcast series is to educate and inform and does not constitute medical or other professional advice or services.Advertising which is incorporated into, placed in associate with, or targeted toward the content of this product, without express approval and acknowledgment of the AAOA, is forbidden.This podcast is available for private, non-commercial use only and may not be edited or modified from its original form or reproduced for distribution.

In the second episode of the AAOA's NEW podcast series Today in ENT Allergy: AAOA's Podcast, Jennifer Villwock, MD, FAAOA speaks with the AAOA's current Presedent (2019-2020) Alpen Patel, MD, FAAOA. They are discussing ENT allergy and the role of otolaryngologists in diagnosis and treatment of allergies.

In the first episode of the AAOA's NEW podcast series Today in ENT Allergy: AAOA's Podcast, Jennifer Villwock, MD, FAAOA speaks with William Reisacher, MD, FAAOA. They are discussing Food Allergy: what is food allergy, food allergy treatment, and the future of food allergy.

Note: The views, information, or opinions expressed during the AAOA podcast series are solely those of the individuals involved and do not necessarily represent those of The American Academy of Otolaryngic Allergy (AAOA) or its employees or members.  The AAOA is not responsible and does not verify for accuracy any of the information contained in and assumes no liability for any activities in connection with this podcast series. The primary purpose of this podcast series is to educate and inform and does not constitute medical or other professional advice or services.Advertising which is incorporated into, placed in associate with, or targeted toward the content of this product, without express approval and acknowledgment of the AAOA, is forbidden.This podcast is available for private, non-commercial use only and may not be edited or modified from its original form or reproduced for distribution.