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Central Compartment Atopic Disease (CCAD): The Defining Clinical Features

Central Compartment Atopic Disease (CCAD): The Defining Clinical Features

by Richard Harvey | Aug 10, 2026 | Nose and Sinus Blog

CCAD is an allergic endoscopic phenotype—not a CT diagnosis Central compartment atopic disease, or CCAD, is often recognised on a sinus CT scan. The central tissues of the nose become thickened while air remains around the outer margins of the sinuses, producing the...
Fungal Ball of the Sinuses: Treat the Failed Sinus, Not Just the Fungus

Fungal Ball of the Sinuses: Treat the Failed Sinus, Not Just the Fungus

by Richard Harvey | Jul 28, 2026 | Nose and Sinus Blog

Why maxillary and sphenoid fungal balls are markers of lost mucociliary clearance A sinus fungal ball is one of the most visually persuasive findings in sinus surgery. The dense fungal material appears to be the disease, so removing it appears to be the treatment. But...
When a Negative Allergy Test Does Not Rule Out Allergy

When a Negative Allergy Test Does Not Rule Out Allergy

by Richard Harvey | Jul 15, 2026 | Nose and Sinus Blog

Medicine diagnoses patients—not laboratory values. A mother brings her 13-year-old child to clinic because she is frustrated. For years, she has watched her child wake most mornings sneezing, rubbing an itchy nose and struggling with nasal congestion. The symptoms are...
Large Septal Perforations: Why“Too Big to Fix”Is No Longer the Right Answer

Large Septal Perforations: Why“Too Big to Fix”Is No Longer the Right Answer

by Richard Harvey | Jul 8, 2026 | Nose and Sinus Blog

Patients with a large septal perforation are often told a simple but discouraging message: “It cannot be fixed. It is too big.” That answer is often incomplete. Large septal perforations are harder to repair than small ones. That part is true. They require more...
Recurrent Sinusitis or Rhinitis? Why It May Not Be Infection

Recurrent Sinusitis or Rhinitis? Why It May Not Be Infection

by Richard Harvey | Jun 28, 2026 | Nose and Sinus Blog

Recurrent Sinusitis or Recurrent Rhinitis? Why Many “Sinus Attacks” Are Not Sinus Infections Many patients use the term “sinus infection” to describe repeated episodes of nasal blockage, facial pressure, thick mucus and feeling unwell. The problem is that these...
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