Endoscopic sinus surgery versus biologic therapy for chronic rhinosinusitis with nasal polyposis: a systematic review with meta-analysis

Biologic therapies targeting type 2 inflammation, such as dupilumab, omalizumab, and mepolizumab, have been developed to manage chronic rhinosinusitis with nasal polyps (CRSwNP), particularly in patients with comorbid asthma or aspirin-exacerbated respiratory disease (AERD). Functional endoscopic sinus surgery (FESS) remains the mainstay of treatment in patients who are refractory to medical therapy (1,2). However, direct comparisons between biologic therapy and FESS are limited. This systematic review and meta-analysis aimed to compare sinonasal outcomes between FESS and biologic therapy in real-world settings.