. 2023 Mar 10;4:1137907. doi: 10.3389/falgy.2023.1137907

Table 1.

Summary of the indications, advantages, disadvantages, cost, and other considerations for various treatment options for patients diagnosed with chronic rhinosinusitis with nasal polyps.

Treatment:	Corticosteroid nasal spray	Corticosteroid saline rinse	Exhalation delivery system with fluticasone	Sinus implant	Biologics (Dupilumab, Omalizumab, Mepolizumab)
How are they used	Nasal spray	Compounded corticosteroid mixed with saline. Examples include NeilMed rinse bottle Nettipot, but multiple delivery devices exist.	Breath powered delivery	Small steroid-coated implant (also referred to as a stent) is placed within your sinus and slowly releases medication over weeks	Self-injected medication under the skin every 2–4 weeks
When are they an option	First-line	First-line	First-line, approved to treat nasal polyps specifically	Recurrence, persistence of symptoms, or postoperative management after sinus surgery	Recurrence or persistence of symptoms after sinus surgery or contraindication to surgery
Advantages of treatment	Simple to use, inexpensive, over the counter	Simple to use, inexpensive, over the counter	Simple to use, reaches certain areas of sinuses better than sprays or rinse	Performed in doctor's office	Treatment option promising for patients who cannot undergo surgery
Disadvantages of treatment	Symptoms from treatment including burning, crusting, and bleeding in the nose	Symptoms from treatment including burning, crusting, and bleeding in the nose	Prescription needed for use, requires breathing coordination	May need repeated procedures	Expensive, may need to continue therapy long-term for relief
Treatment cost^a	$	$	$$	$$–$$$	$$$$
Other important information	May be used concurrently with another therapy	May be used concurrently with another therapy	Must be used every day and only available in one type (fluticasone)	Previous sinus surgery must have been performed on the ethmoid sinus to be eligible.	Relatively new therefore no information on long-term outcomes

^{^a}

$ indicates a relative range of cost with $ in reference to lower cost and $$$$ to more expensive cost.

Adapted from Shared Decision-Making Tools developed by the American Rhinologic Society and American College of Allergy, Asthma, and Immunology (94,95).