Is surgery or Dupilumab better for nasal polyps treatment?

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Your symptoms of persistent nasal blockage, reduced smell, CT (computed tomography) evidence of bilateral polyps, high IgE (immunoglobulin E), and raised eosinophils all point to chronic rhinosinusitis with nasal polyps (CRSwNP), which is commonly linked with underlying allergy or asthma and is part of what is sometimes called the “united airway disease.”

The family history of asthma and your elevated allergy markers suggest that your polyps are indeed related to an allergic or eosinophilic inflammatory process. Standard treatment usually involves a combination of surgery (functional endoscopic sinus surgery) to physically remove the polyps and open up the sinuses, along with steroids (nasal sprays or short courses of oral steroids) to reduce inflammation and slow recurrence.

However, as you have heard, recurrence is possible, especially when the underlying inflammation is strong. Biologic injections such as Dupilumab, and in some cases Mepolizumab or Omalizumab, are newer targeted therapies that block specific inflammatory pathways and have been shown to significantly reduce polyp size, improve smell, decrease the need for repeat surgery, and also benefit asthma control if it coexists.

The decision between surgery and biologics often depends on severity, how much the polyps affect your quality of life, whether you have coexisting asthma, and practical considerations like cost and long-term availability of the biologic. Many patients undergo surgery first, especially if the blockage is severe, and then use biologics if polyps recur or if they are accompanied by uncontrolled asthma.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.