What We Know about Nasal Polyposis: The Clinician’s Point of View

Nasal polyposis is defined by a Th2-driven chronic inflammation of the nose and sinus with polyps visible in the nasal fossae. It is a prevalent disease with a significant impact on the HRQL. Allergy, allergic rhinitis, asthma, and aspirin intolerance are frequently associated. The management is individual. The first line of treatment is a long-term treatment with intranasal corticosteroids. Oral corticosteroids should be used with caution. When the medical treatment fails the patient is eligible for sinus surgery. In case of symptomatic recurrence after both medical treatment and ethmoidectomy, biologics are nowadays a very promising treatment effective on all the respiratory tract. Dupilumab seems in the literature the molecule of choice. However, besides the international guidelines published by EPOS and Euforea, the molecule prescribed depends also on the availability of it in each country and the criteria edited by the health authorities to get reimbursement. Long treatment is mandatory. Traditional medical treatment is necessary as a complement to biologics.