Surgery vs. Biologics for Nasal Polyps: What Doctors Know…

About this episode

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. 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? Guest Bio Dr. Tassos Hantzakos is a staff physician in the Otolaryngology Department at Cleveland Clinic Abu Dhabi’s Integrated Surgical Institute, where he also serves as Program Director of the Otolaryngology Residency. His clinical expertise spans otolaryngology, rhinology, phonosurgery, laryngeal laser surgery, and voice disorders. Before joining Cleveland Clinic Abu Dhabi, Dr. Hantzakos served as a consultant within the Hellenic National Health System, Director of the Voice Clinic at NUKA, and Clinical Associate Professor at Cleveland Clinic Lerner College of Medicine in the US. He has contributed to numerous international journal articles and textbooks and is actively involved in several professional societies, including the European Laryngological Society, the International Association of Phonosurgeons, the Voice Foundation, and the European Society for Swallowing Disorders. Outside of medicine, he enjoys spending time with his family, long-distance running, triathlons, and playing guitar and drums. Connect with him on LinkedIn. Dr. Dipa K. Sheth is an allergist-immunologist based in Washington, DC, and an Assistant Professor of Medicine at Uniformed Services University of the Health Sciences. Her clinical work focuses on allergy and immunology, with experience treating conditions such as chronic sinusitis, rhinitis, atopic