What is the Optimal Method for Steroid Delivery in the Treatment of Chronic Rhinosinusitis With Nasal Polyps?

Chronic rhinosinusitis (CRS) is a prevalent heterogeneous inflammatory disorder of the sinonasal mucosa affecting up to 12.5% of the global population.1 Clinically, CRS can be classified as either CRS without nasal polyp (CRSsNP) or CRS with nasal polyp (CRSwNP). Based on the tissue immunological profile, CRSwNP can be further divided into eosinophilic CRSwNP (ECRSwNP) and non-eosinophilic CRSwNP, which also exhibit different geographic and racial distributions.2 Among the subtypes, ECRSwNP possess clinical significance due to its relatively severe disease expression, high rate of disease recurrence after surgery, and comorbid asthma.3 The refractory and recurrent conditions mainly come from the skewed type 2 inflammation with defective regulatory T-cell functions in ECRSwNP that have negative effects on many factors detrimental to sinus disease.4,