Surgery vs. Biologics for Nasal Polyps: What Doctors Know Now w/ Dr. Tassos Hantzakos & Dr. Dipa Sheth

When it comes to treating chronic sinus disease with nasal polyps…what’s the best approach, surgery or biologics?

Well, the answer is it’s usually not either-or anymore.

When patients are trying to manage these challenging conditions, some people opt for one or the other. But more physicians are finding that surgery and biologics aren’t different paths. They are actually treatment protocols that complement each other.

Surgery may remove the growths, but it doesn’t necessarily stop the process of creating them in the first place. Biologics may suppress the inflammatory pathways driving recurrence, but they don’t physically restore blocked sinus anatomy or remove bulky disease.

We’re entering a new phase of care where the question is no longer “surgery or biologics?” but how both can work together as part of a personalized strategy.

Instead of treating every patient the same way, physicians are now looking deeper at the inflammatory pathways driving disease, recurrence risk, quality of life, and even how different biologics target different parts of the immune cascade.

The shift is moving chronic sinus care away from a one-size-fits-all model and toward precision medicine that’s designed around the individual patient.

In this episode, I’m joined by Dr. Tassos Hantzakos, staff physician in otolaryngology and residency program director at Cleveland Clinic Abu Dhabi, and Dr. Deepa Sheth, allergy and immunology specialist.

Together, we break down how the treatment landscape for chronic rhinosinusitis with nasal polyps is evolving, why collaboration between ENT and allergy specialists is becoming essential, and how biologics are reshaping the future of inflammatory airway disease management.

The use of biologics has more value when they are used after surgery in order to prevent recurrences rather than as the first line of treatment. -Dr. Tassos Hantzakos

 

Things You’ll Learn In This Episode 

Not just a surgical problem
For decades, treatment focused on physically removing nasal polyps, but many patients still experienced recurrence. Why does surgery alone often fail to stop the disease?

Biologics are changing how we think about airway disease
New biologic therapies are targeting different parts of the inflammatory cascade. How do physicians decide which biologic is the best fit for a specific patient?

The future of treatment is collaborative, not competitive
The conversation is shifting away from “surgery versus biologics” toward integrated care between ENT surgeons and allergists. When should surgery come first, and when should biologics be introduced?

Precision medicine is reshaping chronic inflammatory care
Different patients may require different treatment approaches. How does identifying the root inflammatory driver completely change long-term management outcomes?