Chronic sinusitis with nasal polyposis is becoming more widely recognized as a Type 2 inflammatory disease but the best treatment strategies for personalized patient treatment and which biomarkers to use to predict treatment success are still being investigated. For some patients, a complete FESS followed by medical therapy is successful at controlling disease recurrence. For others, this is not the case, sometimes requiring numerous additional surgeries to control the burden of disease. There is the potential to use available biomarkers and patient profile characteristics to direct therapy to minimize the need for further additional surgery and corticosteroid use. In addition, with more than one FDA approved biologic for nasal polyps available and additional Phase three trials combining biologic use with surgery, otolaryngologists face not only the clinical dilemma of if a biologic agent is necessary, but also which one to use and when to initiate the agent--before considering additional surgery, after performing surgery, or concurrently. This panel uses updated patient cases with biomakers, images, and videos, as well as currently available evidence and guidelines, to discuss different therapeutic approaches to treatment and ways to potentially answer the questions: Who will do well with just surgery and medicated rinses? If a biologic is needed, which one is best to use, and when to initiate it?