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Chronic rhinosinusitis with nasal polyps (CRSwNP) is an eosinophilic inflammatory disease that is associated with significantly impaired quality of life due to severe congestion, nasal drainage, facial pain and pressure, and anosmia. It is frustrating for both patients and clinicians, because the lack of effective medical treatment frequently leads to endoscopic sinus surgery (ESS), with as many as 30% of surgery patients requiring further revisional surgeries.
In an open-label, pragmatic trial, 238 Dutch patients with CRSwNP were randomized to ESS with usual care or to usual medical care alone (typically, chronic nasal steroids with saline rinses and short bursts of oral steroids and antibiotics). After 1 year, improvement was statistically…