Combined medical and surgical therapy for chronic rhinosinusitis with nasal polyposis

The Article by Evelijn S Lourijsen and colleagues1 suggests a significant but clinically irrelevant effect of combining endoscopic sinus surgery (ESS) with medical therapy in chronic rhinosinusitis with nasal polyposis (CRSwNP) for the primary outcome of sinonasal outcome test 22. Notably, patients with asthma and CRSwNP have higher type-2 biomarkers as peripheral blood eosinophils and fractional exhaled-breath nitric oxide than patients with asthma alone.2 Such elevated type-2 biomarkers are associated with a better response to corticosteroid therapy.