Chronic rhinosinusitis (CRS) refers to inflammation of the nasal cavity and paranasal sinuses with symptoms lasting more than 12 weeks [1]. The incidence of CRSwNP varies according to the geographical location where studies are done and ranges from 2.7% to 33%. It has a high association with bronchial asthma (BA), aspirin exacerbated respiratory diseases (AERD) and allergic fungal rhinosinusitis (AFRS) [2, 3]. CRSwNP patients whose disease is poorly responsive to medical therapies and have persistent signs and symptoms of nasal blockage and disturbed sense of smell may need to undergo endoscopic sinus surgery in order to decrease the inflammatory burden of the disease, alleviate obstructive nasal symptoms, and facilitate medication delivery to the sino-nasal cavity. CRSwNP patients with recalcitrant symptoms despite maximal medical and surgical therapy have an essential need for close monitoring and rapid interventions to optimize symptom control.