Inclusion Criteria:  - 1- Adult patients (aged 18 years and over) 2- Bilateral denovo nasal polyps confirmed by nasal endoscopy and CT scan.  Exclusion Criteria:  - 1- CRS patients without nasal polyposis. 2- Patient with unilateral nasal polyp. 3- Revision cases (history of previous surgical treatment). 4- Patient with fungal rhinosinusitis.. 5- Pregnancy and lactation. 6- Malignancies.