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Assessing Surgical Extent Before Biologic Therapy for CRSwNP
Alison J Yu1, Kristina A LaPointe1, Kaitlyn Ann Roberts1
1Department of Otolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA.
International Forum of Allergy & Rhinology
|July 20, 2026
Summary
Most patients did not have sinus surgery before starting biologics, with frontal sinus surgery being the least common. This highlights a gap in surgical management prior to biologic therapy for sinus conditions.
Area of Science:
- Otolaryngology
- Immunology
- Surgical Oncology
Background:
- Biologics represent a significant advancement in treating chronic rhinosinusitis with nasal polyps (CRSwNP).
- Previous sinus surgery is a common factor considered in patients undergoing biologic therapy.
- The extent and type of prior sinus surgery may influence treatment outcomes.
Purpose of the Study:
- To evaluate the prevalence of prior sinus surgery in patients initiating biologic therapy for CRSwNP.
- To identify which sinus regions were most and least frequently addressed surgically before biologics.
Main Methods:
- Retrospective chart review of patients with CRSwNP initiating biologics.
- Analysis of surgical history, including type and extent of sinus surgery.
- Categorization of sinus involvement and surgical procedures.
Main Results:
- Nearly two-thirds of patients had no prior sinus surgery or incomplete surgery.
- The frontal sinus was the least surgically addressed sinus among all patients.
- A significant proportion of patients lacked adequate surgical management before biologics.
Conclusions:
- A substantial number of patients commence biologic therapy without adequate prior sinus surgery.
- The under-addressing of frontal sinus surgery prior to biologics may warrant further investigation.
- Optimizing surgical management before biologics could be crucial for treatment success.