4.　Rhinology International Symposium

Chronic rhinosinusitis with nasal polyps(CRSwNP) , which is a chronic disease, presents a challenge for clinicians.Recent advancements have been developed to treat recalcitrant CRSwNP.However distinguishing CRS by merely the presence of nasal polyps do not allow for high efficacy.Therefore understanding endotypes, distinct subgroups defined by underlying molecular and immunological mechanisms, has allowed for development and use of monoclonal antibodies (MAB)targeting specific inflammatory cytokines.These MAB are also known as biologics.Understanding these endotypes holds the promise to targetted therapeutic approaches, particularly within the realm of biologic agents.CRSwNP, increasingly recognized as a Type 2 inflammatory condition, significantly impacts patients' quality of life.However, optimal treatment strategies remain an ongoing area of investigation.Clinicians are actively determining which biomarkers can reliably predict treatment success.Endotypes represent a departure from the one-sizefits-all approach.As clinician scientist delve into cytokine profiles, inflammatory cells, and epigenetics to define endotypes, we hope to provide long lasting control of CRSwNP such as remission and possibly into cure of CRSwNP.Understanding endotypes empowers us to move beyond generic therapies.Precision or better yet, targeted medicine becomes feasible.Tailoring treatments based on endotype-specific characteristics promise improved patient outcomes.While some patients achieve disease control with complete FESS followed by medical therapy, such as topical steroids.Others find this approach insufficient for control of CRSwNP.Often endoscopic sinus surgery and medical therapy alone fail to manage the disease burden, necessitating multiple additional surgeries.The emergence of FDAapproved biologics for nasal polyps represents a significant advancement.However not all biologics have similar efficacy.CRSwNP endotype may affect the efficacy of the biologic.Also there are post market studies exploring the option of combining biologic therapy with surgical interventions such as sinus surgery.Biomarkers and patient characteristics guide therapy decisions, potentially minimizing the need for further surgery and reducing the use of systemic corticosteroid and antibiotic.The evolving landscape of CRSwNP treatment involves a balance between surgery and medical therapy including biologics.By leveraging biomarkers and evidence-based guidelines, we aim to tailor treatments for individual patients.Excitingly, these discussions contribute to better outcomes for those affected by nasal polyposis.