Baldwin

Researchers are evaluating two surgical techniques, reboot surgery and conventional full house Functional Endoscopic Sinus Surgery (FESS), in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) that has not responded to previous treatments. CRSwNP is a condition linked to type-2 inflammation causing severe symptoms and frequent recurrences that affect quality of life and increase healthcare costs. The study aims to compare the effectiveness and safety of these two surgeries, focusing on reducing polyp recurrence and improving symptom-free periods over 24 months. The study compares the reboot operation, which involves complete removal of inflamed sinus mucosa down to the bone to reset the inflammatory environment, with the conventional FESS operation. Both procedures are endoscopic nasal surgeries performed to treat refractory CRSwNP. The reboot approach is designed to promote healthier mucosal regeneration and potentially reduce the need for repeated interventions. Participants will undergo one of these surgical methods for treatment. Participants will be adults aged 18 to 75 years with confirmed type-2 endotype CRSwNP and prior treatment failures. Researchers will monitor outcomes including 24-month recurrence rates of polyps, time to first recurrence, quality of life improvements using the SNOT-22 questionnaire, reduction in systemic corticosteroid use, complication rates such as bleeding or infection, and cost-effectiveness. Follow-up will assess safety and long-term benefits of each surgical approach.