Central Compartment Atopic Disease: What Are the Defining Clinical Features?

Purpose of ReviewThe goal of this narrative is to educate clinicians on the pathophysiology, clinical presentation, radiologic findings, and treatment strategies of central compartment atopic disease.Recent FindingsCentral compartment atopic disease (CCAD) is a relatively recently described chronic rhinosinusitis phenotype involving polypoid changes of central sinonasal compartment related to inhalant allergy exposure. This review highlights the current understanding of the pathophysiology of CCAD, relevant history, physical exam findings, and radiologic hallmarks in order to allow for appropriate clinical management.SummaryCCAD is a diffuse type 2-mediated inflammatory phenotype that initially includes polypoid changes of central sinonasal compartment. This is a response to inhalant allergen deposition in the area. Initial treatment includes management of their allergy via immunotherapy. In cases with sinus obstruction from edema of the central compartment, management includes endoscopic sinus surgery. There are differing views on the extent of surgery for these patients.