Surgical treatment of nasal polyps: past, present, and future

Considerable changes have taken place over the last two decades in the surgical approach to nasal polyposis. The advent of the endoscope has enabled earlier detection and less traumatic and more precise surgical treatment of diseases presenting with nasal polyps. The concept of functional endoscopic sinus surgery (FESS) offers individualized surgery according to the respective patient's disease, and routine radical surgical procedures can be avoided with good functional results. In patients with aspirin intolerance, allergic fungal sinusitis and asthma, nasal polyposis is histologically dominated by dense eosinophilic infiltration and requires a more aggressive approach, often involving combined therapy with corticosteroids. In these cases, extensive postoperative care and follow-up is required to preserve the good postoperative result and to prevent regrowth of polyps.