Postoperative Prevention of Recurrence after Polypectomy: Pathogenesis-Driven Prophylactic Approaches and Modern Strategies

Abstract

Surgical removal of nasal polyps—through conventional polypectomy or functional endoscopic sinus surgery (FESS)—remains one of the principal treatment modalities for chronic rhinosinusitis with nasal polyps (CRSwNP). However, owing to its immuno-inflammatory nature, the condition demonstrates a high recurrence rate, reaching 20–60% within 6–12 months and up to 78% within 1–3 years in severe eosinophilic phenotypes. This article provides an in-depth analysis of the molecular and immunopathological mechanisms underlying recurrence after polypectomy, identifies the major risk groups, and reviews the most evidence-based postoperative prophylactic strategies currently recommended in international clinical guidelines.