“…This research validates prior observational work in the literature, and also at our institution, that topical therapy is effective for refractory chronic rhinosinusitis in general, but furthermore, it assesses the impact of topical therapy specifically on the refractory chronic rhinosinusitis with nasal polyps and refractory chronic rhinosinusitis without nasal polyps subgroups, two conditions that differ widely in their pathophysiology and clinical behaviour. Chronic rhinosinusitis with nasal polyps is more associated with a T‐helper type 2 immune response, and chronic rhinosinusitis without nasal polyps is more associated with a T‐helper type one response …”